Awake, Walking, and Intubated – The ICU Breakthrough Giving Patients Their Lives Back

If they knew what it's like for patients surviving after the ICU, that sedation isn't sleep, and that they're being so traumatized and damaged by these normal practices, they would change this. Picture this: it's your... read more

Early Deep-to-light vs. Continuous Light Sedation for ICU Patients with Mechanical Ventilation

Compared to the continuous light sedation, early deep-to-light sedation strategy was associated with improved patient outcomes, and continuous deep sedation was confirmed with poorer patient outcomes. In total, 6700 patients... read more

Reducing Deep Sedation and Benzodiazepine Use in Mechanically Ventilated Patients During Critical Care Transport

The rate of deep sedation in this cohort was consistent with previously published data; however, it remains higher than clinically indicated. Over the course of the QI project, the proportion of deeply sedated patients... read more

Early Reapplication of Prone Position During VV-ECMO for ARDS

A combination of prone positioning (PP) and venovenous extracorporeal membrane oxygenation (VV-ECMO) is safe, feasible, and associated with potentially improved survival for severe acute respiratory distress syndrome (ARDS).... read more

How to end quiet suffering in the ICU? Identifying and treating hypoactive delirium

The duration of time a person spends in hypoactive delirium predicts higher rates of death, longer length of stay, higher costs of care, and higher rates of acquired dementia in the months and years following critical illness.... read more

Ketamine for Treatment-Resistant Depression

This book brings together an international group of clinicians and researchers from a broad swath of inter-related disciplines to offer the most up-to-date information about clinical and preclinical research into ketamine... read more

Ketamine for Treatment-Resistant Depression

Impact of a Rounding Checklist Implementation in the Trauma ICU on Clinical Outcomes

We aimed to evaluate the effectiveness of an intensive care unit (ICU) round checklist, FAST HUGS BID (Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, Ulcer prophylaxis, Glycemic control,... read more

EEG Patterns for Predicting Poor Outcome After Cardiac Arrest

The specificity of the ERC-ESICM-recommended EEG patterns for predicting poor outcome after cardiac arrest exceeds 90% but is lower than in previous studies, suggesting that large-scale implementation may reduce their accuracy.... read more

Ineffective Airway Clearance Nursing Diagnosis & Care Plans

Ineffective airway clearance is the inability to clear secretions or obstructions from the respiratory tract. This can be detrimental to breathing and create complications. Secretions can be problematic as a result of... read more

Scheduled Intravenous Opioids

Maintaining comfort and analgesia is fundamental to providing adequate care in intensive care unit (ICU) patients. Pain assessment and its control remain the highest priorities and concerns among survivors of critical illness... read more

Propofol-Related Infusion Syndrome in a Child with RSE

Propofol is used for sedation, anxiolysis, anesthesia induction, and as an anticonvulsant. In cases of refractory status epilepticus (RSE), propofol is more efficient than barbiturates. We present a case of a 3-year-old... read more

Haloperidol Efficacy to Decrease Delirium Burden in Critically Ill Patients

This trial, that was stopped early, did not show evidence that haloperidol reduces delirium and coma in critically ill patients with delirium. The beneficial effects on some agitation-related outcomes and lower sedative... read more

Delirium Treatment with Haloperidol Not Associated with Higher Risk of QTc-interval Prolongation

Delirium treatment with haloperidol and/or pipamperone was not associated with a higher risk of QTc-interval prolongation in this naturalistic patient sample but was greater in magnitude and correlated with equipotent dosage... read more

Haloperidol and Delirium: What is Next?

Haloperidol is, by far, the best-studied antipsychotic in ICU, appears to be safe in the dosing range used in these two trials and is easy to administer and titrate. For these reasons, if a clinician chooses to pharmacologically... read more

Nasotracheal vs. Orotracheal Intubation for Sedation in Critically Ill Patients

Nasotracheal intubation (NTI) may be used for long term ventilation in critically ill patients. Although tracheostomy is often favored, NTI may exhibit potential benefits. Compared to orotracheal intubation (OTI), patients... read more

Safety and efficacy of dexmedetomidine vs ketamine vs midazolam combined with propofol in gastrointestinal endoscopy for cancer patients

In cancer patients who underwent GI endoscopy, dexmedetomidine-propofol and ketamine-propofol had better sedation efficacy [lower achievement time of RSS 3–4, total propofol dose, and eye-opening time] compared to midazolam-propofol... read more

Propofol in ICU Settings: Understanding and Managing Anti-Arrhythmic, Pro-Arrhythmic Effects, and Propofol Infusion Syndrome

Propofol has revolutionized anesthesia and intensive care medicine owing to its favorable pharmacokinetic characteristics, fast onset, and short duration of action. This drug has been shown to be remarkably effective in numerous... read more

Dexmedetomidine for EOL Sedation

This study demonstrates a reduction in breakthrough medication requirements, particularly benzodiazepines, for patients sedated with dexmedetomidine at end of life (EOL). The dexmedetomidine cohort required less breakthrough... read more

Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU

A world-renowned critical care doctor offers hope for ICU patients and their families in this timely, urgent, and compassionate narrative. Over the next ten years, 40 to 60 million people in this country will be admitted... read more

Every Deep-Drawn Breath: A Critical Care Doctor on Healing, Recovery, and Transforming Medicine in the ICU

ICU Delirium – A Decade of Learning

Think of delirium as the phenotypic manifestation of global, acute brain dysfunction that can deprive patients of their dignity. This syndrome of acute changes in awareness, attention, and cognition is an independent... read more

Bronchoscopy in ICU: A Practical Guide

This practical guide focuses on Bronchoscopy in ICU. Bronchoscopy is one of the most commonly performed medical procedures, but is limited to the practice of a handful chest physicians and surgeons. The field of bronchoscopy... read more

Bronchoscopy in ICU: A Practical Guide

Ciprofol Sedation Efficacy and Safety in Mechanical Ventilated ICU Patients

Ciprofol was well tolerated, with a noninferior sedation profile to propofol in Chinese ICU patients undergoing MV for a period of 6–24 hours. Of the 135 patients enrolled, 129 completed the study. The primary endpoint-sedation... read more