Disruptive Technology or Standard of Care?

The study and practice of medicine is constantly changing. Hospitals and specialty societies develop protocols and standards of care based on what is thought to be the best evidence and science at the time. Over the years,... read more

Differential Diagnosis Between Newly Diagnosed Asthma and COPD Using EBC Metabolomics

Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases with high pathological burden and healthcare costs. In the outpatient clinical practice, an accurate differential diagnosis is often very... read more

Differences in Impact of Definitional Elements on Mortality Precludes International Comparisons of Sepsis Epidemiology

Within a sepsis cohort, we illustrate case-mix heterogeneity using definitional elements (infection source and organ dysfunction). In the context of improving outcomes, we illustrate differential secular trends in impact... read more

Monitoring ICU Performance-impact of a Novel Individualised Performance Scorecard in Critical Care Medicine

Patients admitted to a critical care medicine (CCM) environment, including an intensive care unit (ICU), are susceptible to harm and significant resource utilisation. Therefore, a strategy to optimise provider performance... read more

Enteral vs Parenteral Nutrition in Critical Care Requiring Mechanical Ventilation

Enteral feeding was not superior to parenteral feeding for early nutritional support in critically ill patients receiving mechanical ventilation and vasopressor support for shock, according to the results of a study published... read more

Prospective Evaluation of a Multifaceted Intervention to Improve Outcomes in Intensive Care

Studies comprehensively assessing interventions to improve team communication and to engage patients and care partners in ICUs are lacking. This study examines the effectiveness of a patient-centered care and engagement program... read more

Liberal Glycemic Control in Critically Ill Patients With Type 2 Diabetes

Ludwig Lin, MD, speaks with Palash Kar, MBBS, about the article, "Liberal Glycemic Control in Critically Ill Patients With Type 2 Diabetes: An Exploratory Study," published in Critical Care Medicine. In this article, Dr.... read more

Factors Associated with Life-Sustaining Treatment Restriction in the ICU

Few previous studies have investigated associations between clinical variables available after 24 hours in the ICU and decisions to restrict life-sustaining treatment. The aim of this study was to identify factors associated... read more

What have been the major recent advances in delirium research and care?

Editor-In-Chief-Elect Giuseppe Citerio discusses the recent article focused on the intensive care delirium research agenda in Intensive Care Medicine (ICM). For this evidence-based paper, a multinational and inter-professional... read more

Barriers and Facilitators to Early Rehabilitation in Mechanically Ventilated Patients

Using a theoretically driven approach, this study identified important barriers and facilitators to early rehabilitation in ICU patients. In particular, the domains of social influences and behavioral regulation were not... read more

Defining Sepsis on the Wards: Comparing Two Sepsis Definitions

Sepsis is defined as a dysregulated host response to infection, resulting in acute organ dysfunction. Although the condition has been thoroughly studied in the intensive care unit (ICU), accurate data collection outside of... read more

Supplemental Parenteral Nutrition vs. Usual Care in Critically Ill Adults

This individually titrated supplemental PN strategy applied over 7 days significantly increased energy delivery when compared to usual care delivery. Clinical and functional outcomes were similar between the two patient groups.... read more

Glycaemic Control Targets After TBI

This meta-analysis of intensive glycaemic control shows no association with reduced mortality in TBI. Intensive glucose control showed a borderline significant reduction in the risk of poor neurological outcome, but markedly... read more

Vascular Access in Critically Ill Pediatric Patients With Obesity

Severe obesity is associated with decreased overall likelihood of placement of a vascular access device but increased likelihood of peripherally inserted central catheter placement and of device-related complications. Patients... read more

Comparison between a nurse-led weaning protocol and weaning based on physician’s clinical judgment in tracheostomized critically ill patients

In this pilot RCT we demonstrated that a nurse-led weaning protocol from tracheostomy was feasible and safe. A larger RCT is justified to assess efficacy. We enrolled 65 patients, 27 were in the protocol group and 38 in the... read more

The 2018-2023 World Outlook for Sepsis Drugs

This study covers the world outlook for sepsis drugs across more than 190 countries. For each year reported, estimates are given for the latent demand, or potential industry earnings (P.I.E.), for the country in question... read more

The 2018-2023 World Outlook for Sepsis Drugs

An attenuated rate of leg muscle protein depletion and leg free amino acid efflux over time is seen in ICU long-stayers

In critically ill patients with sustained organ failure and in need of a prolonged ICU stay, the initial high rate of skeletal muscle protein depletion was attenuated over time. The distinction between the acute phase and... read more

Importance of Second Antibiotic Doses in ED Sepsis Patients

Most studies evaluating early antibiotic administration in sepsis patients focus on timing of the first dose. We highlight many of these studies in our recent review article on Appropriate Antibiotic Therapy in Emergency... read more

The Case of the Relative Insufficiency

When it comes to the efficacy of glucocorticoid therapy for the treatment of septic shock, we have existed in a state of ambiguity, torn between the results of two contradictory RCTs. The first, the Annane et al trial published... read more

Is Fever the Normal Temperature of Sepsis

We know that hypothermia in sepsis is associated with increased mortality but other than that we tend to see fever in sepsis as something bad. We tend to perceive sepsis patients as more sick the more the temperature is elevated.... read more

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock

Among patients with septic shock undergoing mechanical ventilation, a continuous infusion of hydrocortisone did not result in lower 90-day mortality than placebo. We randomly assigned patients with septic shock who were undergoing... read more

Neural Breathing Pattern and Patient-Ventilator Interaction During Neurally Adjusted Ventilatory Assist and Conventional Ventilation in Newborns

Patient-ventilator interaction appears to be improved with neurally adjusted ventilatory assist. Analysis of the neural breathing pattern revealed a reduction in central apnea during neurally adjusted ventilatory assist use.... read more