It’s Insane to Keep Using Mortality As a Primary Endpoint in Critical Care Trials

Mortality is an important endpoint, so we shouldn't ignore mortality trends entirely. However, the vast majority of these will be spurious. Thus, we should generally not change practice due to them. In the history of critical... read more

Tranexamic Acid in TBI – CRASH-3 Trial Treatment

The CRASH-3 trial is a multi-centre, randomised, placebo-controlled trial of the effects of tranexamic acid on death and disability in patients with traumatic brain injury (TBI). Patients with reactive pupils and/or mild... read more

Relative Hyperglycemia Predicts In-Hospital Mortality in Critically Ill Patients

Unlike absolute hyperglycemia, relative hyperglycemia, as assessed by the stress hyperglycemia ratio, independently predicts in-hospital mortality in critically ill patients across the glycemic spectrum. Future studies should... read more

The Faster Cooling Rate and More Stable Cooling Process in Endovascular Cooling Shorten Patients’ Time in ICU

This study conducted a meta-analysis to assess the effectiveness, stability, and safety of mild therapeutic hypothermia (TH) induced by endovascular cooling (EC) and surface cooling (SC) and its effect on ICU, survival rate,... read more

Potential Therapy for Improving Sudden Cardiac Arrest Resuscitation Outcomes

The severity of cardiogenic shock following asystolic cardiac arrest is dependent on the length of cardiac arrest prior to cardiopulmonary resuscitation and is mediated by myocardial stunning resulting from mitochondrial... read more

Safe Transfer of the Brain-injured Patient

The document considers recent developments in the management of multiply-injured patients and those with acute ischaemic stroke. Whilst many of the principles of safe transfer are common to all seriously ill patients,... read more

Epinephrine During Resuscitation of Traumatic Cardiac Arrest and Increased Mortality

Epinephrine administered during in-hospital resuscitation was associated with lower 7-day survival rate in patients with out-of-hospital cardiac arrest (OHCA) following trauma. While we examined the outcomes of selected... read more

Should We Treat Fever in Critically Ill Patients Without Acute Brain Pathology?

In one of the sessions at #LIVES2019 in Berlin, Prof. Frank Van Haren of Canberra Hospital, Australia, presented findings from the Randomised Evaluation of Active Control of Temperature versus Ordinary Temperature Management... read more

Early Identification of Disease Progression in Patients with Suspected Infection Presenting to the ED

In patients presenting to the emergency department (ED) with a suspected infection, the blood biomarker MR-proADM could most accurately identify the likelihood of further disease progression. Incorporation into an early sepsis... read more

Health Coaching to Increase Appropriate Inhaler Use in COPD

Health coaching may provide a scalable model that can improve care for people living with chronic obstructive pulmonary disease (COPD). Baseline adherence and inhaler technique were uniformly poor and did not differ by... read more

Lifting the Impenetrable Veil: From Yellow Fever to Ebola Hemorrhagic Fever & SARS

This book tells their communal story, the story of medical history, entomology, vector-borne diseases, virology, epidemiology and related fascinating but little recognized disciplines Interweaving his own personal stories... read more

Lifting the Impenetrable Veil: From Yellow Fever to Ebola Hemorrhagic Fever & SARS

Global, Regional, and National Sepsis Incidence and Mortality: 1990-2017

Globally, there were an estimated 60.2 million cases of sepsis in 1990 and 48.9 million cases of sepsis in 2017. This change represents a decrease of 18.8%. Of all incident cases of sepsis in 2017, 33.1 million occurred... read more

Soluble Urokinase Receptor and AKI

The authors concluded that high suPAR levels were associated with Acute Kidney Injury (AKI) in various clinical and experimental contexts. This cohort study reports that suPAR was associated with subsequent AKI in several... read more

A Team Response to a Potential Killer: Sepsis

Our bodies are very good at fighting infection. The immune system reacts and attacks bacteria and viruses that make us sick. But sometimes the immune reaction is so strong that it damages the body. This is called a septic... read more

Prone Positioning Monitored by Electrical Impedance Tomography in Patients with Severe ARDS on VV-ECMO

Prone positioning (PP) during veno-venous ECMO is feasible, but its physiological effects have never been thoroughly evaluated. Our objectives were to describe, through electrical impedance tomography (EIT), the impact of... read more

Tranexamic Acid Has Nominal Benefit for TBI

Studies examining the use of tranexamic acid (TXA) inescapably seem to pit our rigorous methodological demons against our practical clinical angels. The CRASH-2 trial randomized 20,211 adult trauma patients presenting... read more

A Prospective Observational Study of High-Dose Intrathecal Diamorphine in Laparoscopic Bariatric Surgery

We have demonstrated that neuraxial blockade is a simple, practical, and feasible technique to adopt. Our case series demonstrated a high level of patient acceptability. 50 patients were included. 11 patients (22%) had... read more

The ABCDE Bundle Associated with Significant Reductions in Duration of Mechanical Ventilation

The focus on long-term consequences of critical illness has intensified with increasing ICU utilization and survivorship. Post Intensive Care Syndrome (PICS) is increasingly recognized and has profound and long-lasting negative... read more

Risk Factors for Septicemia Deaths and Disparities in a Longitudinal US Cohort

In this cohort, the major risk factors for septicemia death were similar to those for other causes of death, there was approximately a 2-fold Black-White disparity in septicemia deaths, and the strongest mediators of this... read more

Conservative vs. Interventional Treatment for Spontaneous Pneumothorax

Although the primary outcome was not statistically robust to conservative assumptions about missing data, the trial provides modest evidence that conservative management of primary spontaneous pneumothorax was noninferior... read more

Time to Recognition of Sepsis in the Emergency Department Using Electronic Health Record Data

Systemic inflammatory response syndrome and Sequential Organ Failure Assessment initially identified distinct populations. Using systemic inflammatory response syndrome resulted in earlier electronic health record sepsis... read more

Best Practice Advisories Improve Sedation Protocol Compliance in the ICU

Best practice advisories can be effectively used in ICUs to improve sedation protocol compliance and may mitigate potential propofol-related hazardous conditions. Best practice advisories should undergo continuous quality... read more