Accuracy of Cumulative Volumes of Fluid Challenge in Critically Ill Patients

Accuracy of Cumulative Volumes of Fluid Challenge in Critically Ill Patients

A volume of fluid challenge (FC) of 250 ml with a threshold of 9.6% increase in stroke volume (SV) showed the highest accuracy in detecting fluid responsiveness in critically ill patients with shock. A prospective observational... read more

Predict Sepsis-Associated Vasopressor Use in the ICU

Predict Sepsis-Associated Vasopressor Use in the ICU

Domain adaptation improved performance of a model predicting sepsis-associated vasopressor use during external validation. 40 retrospectively collected features from the electronic medical records of adult ICU patients... read more

Cardiac Injury in COVID-19

Cardiac Injury in COVID-19

Patients with coronavirus disease 2019 (COVID-19) can present with a large panel of cardiac manifestations, including myocardial infarction with (type 1) or without (type 2) obstructive coronary artery disease, arterial or... read more

Subtle Presentations of Shock in the ED Setting

Subtle Presentations of Shock in the ED Setting

The patient was a 2-year-old female with a history of allergy to peanuts who was brought to the emergency department by her mother because of a complaint of allergic reaction. Twenty minutes prior to arrival, the patient... read more

Angiotensin II in Post Cardiopulmonary Bypass Vasoplegia

Angiotensin II in Post Cardiopulmonary Bypass Vasoplegia

Post cardiopulmonary bypass vasoplegia is common, and associated with poor outcomes. Traditional management strategies involving escalating doses of catecholamines, vasopressin and adjuncts such as methylene blue and hydroxycobalamin... read more

Validation of a Point-of-Care Capillary Lactate Measuring Device

Validation of a Point-of-Care Capillary Lactate Measuring Device

Lactate Pro 2 had good agreement with the reference method using arterial blood but poorer agreement using venous blood. Our results show the potential for overestimation of the lactate values in haemodynamically compromised... read more

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding

In patients with high risk upper GI bleeding, who were treated with pre-endoscopy PPI and were not in persistent shock, an endoscopy performed at a median of 10 hours vs. a median of 25 hours post presentation did not reduce... read more

Physiologic Assessment: Variation in Fluid and Vasopressor Use in Shock

Physiologic Assessment: Variation in Fluid and Vasopressor Use in Shock

The decision whether to give more fluid during the management of shock can be somewhat provider-dependent. This multicenter prospective cohort study evaluated 1639 patients with hypotension requiring vasopressors. The... read more

An Evidence-Based Approach to Pressors in Shock

An Evidence-Based Approach to Pressors in Shock

The evaluation and treatment of patients with cardiovascular shock is a cornerstone of emergency care. Unfortunately, the literature behind the use of vasoactive medications in cardiovascular shock is inconsistent. A Cochrane... read more

Guidelines for Burn Care Under Austere Conditions

Guidelines for Burn Care Under Austere Conditions

The principles of care after disasters and mass casualty incidents are centered on doing the greatest good for the greatest number. From an airway and ventilation perspective, we have presented the issues that are likely... read more

Healthcare Provider Perceptions of Cardiopulmonary Resuscitation Quality During Simulation Training

Healthcare Provider Perceptions of Cardiopulmonary Resuscitation Quality During Simulation Training

Cardiopulmonary resuscitation performance during mock codes does not meet the American Heart Association's quality recommendations. Healthcare providers have poor insight into the quality of cardiopulmonary resuscitation... read more

Antipsychotics Not Helpful for Delirium in ICU

Antipsychotics Not Helpful for Delirium in ICU

Delirium is a confused mental state that includes changes in awareness, thinking, judgment, sleeping patterns, and behavior. It can affect patients of any age but is more common among older adults who experience major illness... read more

Vasopressors and Inotropes for Shock Syndromes

Vasopressors and Inotropes for Shock Syndromes

Vasopressors and inotropes are cornerstones in the management of shock syndromes. Understanding vasopressors' receptor activity and resultant pharmacological response enables clinicians to select the ideal vasopressor(s)... read more

Similar Metabolic, Innate Immunity, and Adipokine Profiles in Adult and Pediatric Sepsis vs. SIRS

Similar Metabolic, Innate Immunity, and Adipokine Profiles in Adult and Pediatric Sepsis vs. SIRS

Sepsis presents with similar profiles in adult and pediatric patients, characterized by enhanced inflammatory hormonal response and by repressed innate immunity, metabolism, and myocardial contractility. These features early... read more

Annals of B-Pod: Neurogenic Shock

Annals of B-Pod: Neurogenic Shock

Shock is defined as the failure of circulation to provide adequate oxygenation to meet cellular demand. To better identify and manage this compromised physiologic state, shock is subcategorized into four... read more

In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope

In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope

In Shock is a riveting first-hand account from a young critical care physician, who in the passage of a moment is transfigured into a dying patient. This transposition, coincidentally timed at the end of her medical training,... read more

Less or More Hemodynamic Monitoring in Critically Ill Patients

Less or More Hemodynamic Monitoring in Critically Ill Patients

The use of echocardiography should be initially encouraged in patients with shock to identify the type of shock and to select the most appropriate therapy. The use of more invasive hemodynamic monitoring techniques should... read more