Extubating Ventilated Patients on Vasoactive Infusions is Safe

Extubating Ventilated Patients on Vasoactive Infusions is Safe

In a large single centre study, 21% of intubated patients who received infusions of vasoactive infusions while mechanically ventilated were extubated for the first time while still receiving them. Coincident with their earlier... read more

Inter-Rater Reliability Between PICU Nurses Performing a Modification to the Glasgow Coma Scale

Inter-Rater Reliability Between PICU Nurses Performing a Modification to the Glasgow Coma Scale

The objective of this study was to estimate the inter-rater reliability of critical care nurses performing a pediatric modification of the Glasgow Coma Scale in a contemporary pediatric intensive care unit (PICU). All... read more

Droperidol Use in the Emergency Department – What’s Old is New Again

Droperidol Use in the Emergency Department – What’s Old is New Again

Earlier this year American Reagent announced the re-introduction of droperidol back into the US market. This is bringing an old favorite back to many EM docs and a novel tool for new residents and attendings who have never... read more

Systemic Early Neuromuscular Blockade in ARDS – The ROSE Trial

Systemic Early Neuromuscular Blockade in ARDS – The ROSE Trial

The early use of neuromuscular blocking agents in the setting of moderate-to-severe acute respiratory distress syndrome (ARDS) was previously understood to confer a survival advantage at 90 days, based on the outcomes of... read more

Sedatives in Neurocritical Care

Sedatives in Neurocritical Care

Extrapolating the findings from studies in the general ICU population suggests to reserve deep continuous sedation in the neuro-ICU for specific indications. Although an improved understanding of cerebral physiological changes... read more

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Premedication of dexmedetomidine at the dose of 1 μg/kg in children undergoing adenotonsillectomy resulted in favorable effect on intraoperative hemodynamics, significant decrease in postoperative EA without causing any... read more

Pharmacotherapy in Neurointensive Care

Pharmacotherapy in Neurointensive Care

Neurointensive care medicine has experienced great advancements and developments of neuromonitoring techniques, allowing a better comprehension of acute brain injury early phase pathological mechanisms and an overall improvement... read more

Ketamine Sedation for Patients With Acute Behavioral Disturbance During Aeromedical Retrieval

Ketamine Sedation for Patients With Acute Behavioral Disturbance During Aeromedical Retrieval

Acute behavioural disturbance(ABD), also known as Excited Delirium Syndrome, is a medical emergency with reported mortality of 8-10%. The management of ABD usually involves a judicious combination of de-escalation techniques,... read more

Sedation in the ICU – Good Past – Better Future?

Sedation in the ICU – Good Past – Better Future?

The concepts for good sedation include defining the range of sedation, the need for agents with rapid response that can be easily and rapidly varied in restless and confused patients, various modes of ventilation, continuous... read more

Organizational Factors Associated with Target Sedation on the First 48 hours of Mechanical Ventilation

Organizational Factors Associated with Target Sedation on the First 48 hours of Mechanical Ventilation

Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role... read more

Sedation Practice in ECMO-Treated Patients with ARDS

Sedation Practice in ECMO-Treated Patients with ARDS

Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective... read more

Sedation in ICU patients – Need for Standardized Protocols

Sedation in ICU patients – Need for Standardized Protocols

A Johns Hopkins-led study on sedation practices in critically ill patients in a resource-limited setting finds that deep sedation, agitation, and benzodiazepines were independently associated with worse clinical outcomes.... read more

Tidal Volume Strategies for those without ARDS

Tidal Volume Strategies for those without ARDS

This paper justifies utilizing a higher tidal volume strategy for our patients without primary ARDS/pulmonary disease. This can be very useful. Patient comfort and patient-ventilator synchrony are extremely important. This... read more

Applied Physiology at the Bedside: Volumetric Capnography

Applied Physiology at the Bedside: Volumetric Capnography

Volumetric capnography is the graphical representation of the partial pressure of carbon dioxide (CO2) versus exhaled volume. This measurement is made noninvasively at every breath by a combination of flow and CO2 sensors,... read more

ICU Physiology in 1000 Words: The Mean Systemic Filling Pressure

ICU Physiology in 1000 Words: The Mean Systemic Filling Pressure

Consider sitting deep within the hull of this cruise ship, ignorant to the outside. A leak is sprung and ocean begins to rush in. Thinking quickly you activate the bilge pump which, appropriately, ejects the ocean outside... read more

A Prospective Investigation of Interleukin-8 Levels in Pediatric ARF and ARDS

A Prospective Investigation of Interleukin-8 Levels in Pediatric ARF and ARDS

The association of plasma interleukin-8 (IL-8), or IL-8 genetic variants, with pediatric acute respiratory distress syndrome (PARDS) in children with acute respiratory failure (ARF) at risk for PARDS has not been examined.... read more

Low-dose Nocturnal Dexmedetomidine Prevents ICU Delirium

Low-dose Nocturnal Dexmedetomidine Prevents ICU Delirium

Dexmedetomidine is associated with less delirium than benzodiazepines, and better sleep architecture than either benzodiazepines or propofol; its effect on delirium and sleep when administered at night to patients requiring... read more