Chasing Mortality Endpoints is a Fool’s Errand

"There is no mortality benefit for that." How many times have you heard that? The implication is usually the same: that intervention is a waste of time. A smart, evidence-based clinician wouldn't bother with it. But, what... read more

Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe TBI

Among patients with severe traumatic brain injury (TBI), early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic... read more

Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia

This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the noninferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in... read more

Antipsychotic Drugs Don’t Ease ICU Delirium Or Dementia

Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine. Antipsychotic medications, such as haloperidol... read more

Initial Trophic vs Full Enteral Feeding in Patients With Acute Lung Injury

In patients with acute lung injury, compared with full enteral feeding, a strategy of initial trophic enteral feeding for up to 6 days did not improve ventilator-free days, 60-day mortality, or infectious complications but... read more

Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients

In this cluster randomized multicenter study in 13 European ICUs, decontamination strategies with either antibiotics (SDD or SOD) or CHX mouthwash were not associated with reductions in ICU-acquired BSI with MDRGNB, nor mortality,... read more

Decontamination of Oral or Digestive Tract for Patients in the ICU

The study by Wittekamp and colleagues in this issue of JAMA evaluating strategies for decontamination of mechanically ventilated patients in the intensive care unit (ICU) fills an important gap in the evidence regarding these... read more

Rudeness in Medical Settings Could Kill Patients

A recent study paints a grim picture of what rudeness does to doctors and nurses performance. The study, "The Impact of Rudeness on Medical Team Performance: A Randomized Trial," which was published in the September... read more

Policies That Limit Emergency Department Visits and Reimbursements Undermine the Emergency Care System

Emergency department (ED) visit rates in the United States have been rising over the past 2 decades, outpacing population growth.1 These visits are portrayed in the lay press as unnecessary visits that must be reduced or... read more

Effect of Targeted Polymyxin B Haemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level

In adult patients with septic shock and high circulating endotoxin activity, does the use of polymyxin B hemoperfusion therapy significantly decrease 28-day mortality? Among patients with septic shock and high endotoxin activity,... read more

An Incurable Disease Is On The Rise In California, And Scientists Say Climate Change Could Cause It To Spread To Much Of The Western US

A fungus that thrives in dry soil and warm weather has caused a record number of infections in California. Experts fear climate change will cause it to spread across the western US. Valley fever, a fungal disease that infects... read more

Stronger evidence for vitamin C use in sepsis treatment

A new meta-analysis reveals a positive correlation between incorporating vitamin C in the treatment of sepsis and favorable patient outcomes. Results of the meta-analysis showed a marked reduction in mortality and duration... read more

Clinical Trial Testing Vitamin and Steroid Combination in Sepsis Patients Underway at Emory

A new clinical trial at Emory University and 45 other sites around the U.S. will test a combination of vitamins and steroids in patients diagnosed with sepsis. Sepsis is caused by the body's overwhelming and life-threatening... read more

Comparing Percutaneous to Open Access for Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure

The proportion of pediatric patients undergoing percutaneous extracorporeal membrane oxygenation cannulation is increasing. Mechanical and physiologic complications occur with both methods of cannulation, but percutaneous... read more

Communicating with Conscious and Mechanically Ventilated Critically Ill Patients

Ventilator-dependent patients in the ICU often experience difficulties with one of the most basic human functions, namely communication, due to intubation. Although various assistive communication tools exist, these are infrequently... read more

Comparison between procalcitonin and C-reactive protein to predict blood culture results in ICU patients

Biomarkers represent an essential tool for identification of patients developing infection and to determine their clinical severity. Procalcitonin (PCT) levels appeared to be correlated with the development of severe bacterial... read more

Meet the trillions of viruses that make up your virome

If you think you don’t have viruses, think again. It may be hard to fathom, but the human body is occupied by large collections of microorganisms, commonly referred to as our microbiome, that have evolved with us since... read more

Alcohol Withdrawal: One Order to Sedate Them All

This is a retrospective cohort study describing 86 admissions to the ICU for alcohol withdrawal between 2011-2015. 86% were treated with benzodiazepines before ICU admission, usually on the general ward. The average dose... read more

Triiodothyronine Replacement in Critically Ill Adults with Non-thyroidal Illness Syndrome

This study suggests that with triiodothyronine (T3) supplementation there was evidence of serum free T3 normalization without evidence of associated harms. A definitive trial is needed to evaluate clinical effectiveness.... read more

Early PREdiction of Sepsis Using Leukocyte Surface Biomarkers

From a large panel of leukocyte biomarkers, immunosuppression biomarkers were associated with subsequent sepsis in ED patients with suspected acute infection. Between January 2014 and February 2016, we recruited 272, 59 and... read more

Organ and Tissue Donation Education for Critical Care Residents

Qualitative data corroborated that residents need more exposure to clinical cases, especially regarding DCD donors. A standardized education curriculum would be beneficial for all residents within the ICU. Developing a better... read more

Abnormal Environmental Light Exposure in the ICU Environment

Patients' environmental light exposure in the intensive care unit is consistently low and follows a diurnal pattern. No effect of nighttime light exposure was observed on melatonin secretion. Inadequate daytime light exposure... read more