Exosomes in Critical Illness

Exosomes are small, cell-released vesicles (40–100 nm in size) with the potential to transfer proteins, lipids, small RNAs, messenger RNAs, or DNA between cells via interstitial fluids. Due to their role in tissue homeostasis,... read more

Nurses are burnt out. Here's how hospitals can help

Studies have found that overworked nurses lead to more errors and lower patient satisfaction. Nurses across the country are stressed, burnt out and thinking of leaving the profession. Surveys, polls and studies of all kinds... read more

Generalizable Biomarkers in Critical Care

The sequencing of the human genome and the subsequent availability of inexpensive, robust methods for "omics" profiling (e.g., genome-wide association studies, gene expression microarrays, and metabolomics) have... read more

Physiological Effects of Chronic Hypoxia

This review examines an array of physiological responses to low cellular oxygen tensions and discusses the effect of increasing oxygen tensions, through oxygen conditioning, on such responses.... read more

Ramped Position versus Sniffing Position during Endotracheal Intubation

A Multicenter, Randomized Trial of Ramped Position versus Sniffing Position during Endotracheal Intubation of Critically Ill Adults. Hypoxemia is the most common complication during endotracheal intubation of critically ill... read more

Early EEG for outcome prediction of postanoxic coma

We recently showed that electroencephalography (EEG) patterns within the first 24 hours robustly contribute to multimodal prediction of poor or good neurological outcome of comatose patients after cardiac arrest. Here, we... read more

Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock

The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine... read more

Using Clinically Accessible Tools to Measure Sound Levels and Sleep Disruption in the ICU

Ambient sound was measured for 1 minute using an application downloaded to a personal mobile device. Bedside nurses also recorded the total time and number of awakening for each patient overnight. Across a large number of... read more

Interprofessional Survey of Perceived Barriers and Facilitators to Early Mobilization of Critically Ill Patients in Montreal, Canada

Early mobilization is safe, feasible, and associated with better outcomes in patients with critical illness. However, barriers to mobilization in clinical practice still exist. The objective of this study was to assess the... read more

The Epidemic of Physician and Medical Student Suicide

In the past decade, numerous studies have shown that physicians and medical students have higher rates of suicide than the general population. The American Foundation for Suicide Prevention reports that over 400 physicians... read more

Principles learned from a successful VTE improvement program

Principles learned from a successful improvement program can increase compliance and reduce hospital acquired VTEs (HA-VTEs) across multiple institutions. Can a single institution’s VTE prophylaxis program be scaled to... read more

Breaking Health Care Rules to Improve Care

This Viewpoint summarizes rules in health care organizations that their own leaders identified as ones that contribute little or no value to care, impede the work of clinicians, frustrate patients and families, and waste... read more

The vaccine study you will never see

I’ve seen a lot of social media posts or comment threads that say we don’t have any studies to prove that the CDC's vaccine schedule is safe or effective. I think they mean that we haven’t done the best study. As... read more

Enhanced Recovery After Surgery Program Implementation

In this pre-post difference-in-differences study of 15 849 surgical patients at 20 medical centers in Northern California, implementation of a multifaceted enhanced recovery program was associated with a one-third reduction... read more

The Impact of Neonatal Simulations on Trainees Stress and Performance

Neonatal simulations cause significant anticipatory and participatory stress. Despite this, trainees' performance score in simulation was over 80%. Simulated death did not impact performance, magnitude of rise in salivary... read more

Primary Stroke Center Protocol for Suspected Stroke by Large-Vessel Occlusion

In this cohort study, when the PSC protocol was fully executed, the rate of good outcomes was doubled and the time from arrival at the PSC to reperfusion at the CSC was almost 1 hour less than that with only a partial execution... read more

Obese Have Less Respiratory Insufficiency Than Nonobese During Endoscopy

Obese patients showed less respiratory insufficiency (RI) than their nonobese counterparts during endoscopic surgery, according to a new study. The result was counterintuitive. Because of their higher rates of obstructive... read more

Reduction In Blood Gas Time To Result In ICU

A recent time and motion study by University Hospital Southampton NHS Foundation Trust has demonstrated a 1.5 minute (>20%) reduction in time to blood gas results when using the Proxima bedside blood gas monitoring system... read more

PTSD, Psychotropic Medication Use, and the Risk of Dementia Among US Veterans

Objective: To determine the associations between PTSD, psychotropic medication use, and the risk for dementia. PTSD diagnosis significantly increased the risk for dementia diagnosis (HR = 1.35; [95% CI = 1.27–1.43]). However,... read more

Blood pressure deficits in acute kidney injury: not all about the mean arterial pressure?

Acute kidney injury (AKI) is associated with increased morbidity and mortality. Although there are many causes of AKI, it is known that patients undergoing high-risk surgery are known to be at significant risk. Although much... read more

What Is Permitted in Text Messaging About Protected Health Information?

This Viewpoint discusses the best use of texting clinical information, noting that neither Health Insurance Portability and Accountability Act nor the Health Information Technology for Economic and Clinical Health Act offer... read more

Albumin Administration in Sepsis: The Case for and Against

Serum albumin is an essential plasma protein, with a variety of homeostatic and predictive roles in health and disease. Hypoalbuminaemia is common in critical illness. Human albumin solution has been administered clinically... read more