Hematologic Challenges in the Critically Ill

Hematologic Challenges in the Critically Ill

This volume provides a comprehensive overview of hematologic issues that clinicians regularly encounter in the critical care environment. The text features hematologic scenarios that affect the adult ICU patient, outlines... read more

Strategies for Mechanical Ventilation in Patients with Brain Injury

Strategies for Mechanical Ventilation in Patients with Brain Injury

Although direct data to guide mechanical ventilation in brain-injured patients is accumulating, the current evidence base remains limited. Ventilatory considerations in this population should be extrapolated from high-quality... read more

Acute Effects of Ketamine on ICP in Children With Severe TBI

Acute Effects of Ketamine on ICP in Children With Severe TBI

In this retrospective, exploratory study, intracranial pressure (ICP) did not increase following ketamine administration. In the setting of a guidelines-based protocol, ketamine was associated with a reduction in ICP during... read more

Intracranial Pressure: Current Perspectives on Physiology and Monitoring

Intracranial Pressure: Current Perspectives on Physiology and Monitoring

Intracranial pressure (ICP) monitoring is now viewed as integral to the clinical care of many life-threatening brain insults, such as severe traumatic brain injury, subarachnoid hemorrhage, and malignant stroke. It serves... read more

Multiple Organ Dysfunction in Older Major Trauma Critical Care Patients

Multiple Organ Dysfunction in Older Major Trauma Critical Care Patients

Frailty rather than chronological age appears to drive multiple organ dysfunction syndrome (MODS) development, recovery, and outcome in older cohorts. Early identification of frailty after trauma may help to predict MODS... read more

Casemix, management, and mortality of patients receiving emergency neurosurgery for TBI

Casemix, management, and mortality of patients receiving emergency neurosurgery for TBI

Patients receiving emergency neurosurgery for traumatic brain injury (TBI) differed considerably in their admission characteristics and management across human development settings. Level of human development was associated... read more

Why Are We Still Talking about ICP and Ketamine?

Why Are We Still Talking about ICP and Ketamine?

A trauma patient required emergent intubation during a recent shift. The altered patient was suspected of having an intracranial bleed. My resident was concerned about rapid onset of hypoxia and other internal injuries causing... read more

Therapeutic Hyperthermia Associated with Improved Survival in Afebrile Critically Ill Patients with Sepsis

Therapeutic Hyperthermia Associated with Improved Survival in Afebrile Critically Ill Patients with Sepsis

Participants randomized to external forced-air warming did not have a difference in HLA-DR expression or IFN-γ production. In this pilot study, however, 28-day mortality was lower in the intervention group. Future research... read more

Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS

Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS

Intravenous fluid therapy is one of the most commonly-performed interventions in all of critical care medicine. Numerous trials over the last 20 years have attempted to identify the ideal fluid for those in the intensive... read more

Cerebral Hypoperfusion Detection with Dynamic Hyperoxia Test

Cerebral Hypoperfusion Detection with Dynamic Hyperoxia Test

In a heterogeneous population of acute brain-injured patients, cerebral multimodal monitoring with intracranial pressure (ICP) and brain tissue oxygen pressure (PbtO2) detected regional cerebral hypoperfusion with a higher... read more

Cluster ICU Treatment Strategies for TBI by Hospital Treatment Preferences?

Cluster ICU Treatment Strategies for TBI by Hospital Treatment Preferences?

Although correlations between treatment policies within domains were found, the failure to cluster hospitals indicates that a specific treatment choice within a domain is not a proxy for other treatment choices within or... read more

Feasibility of Conservative Fluid Administration and Deresuscitation vs. Usual Care

Feasibility of Conservative Fluid Administration and Deresuscitation vs. Usual Care

A strategy of conservative fluid administration and active deresuscitation is feasible, reduces fluid balance compared with usual care, and may cause benefit or harm. In view of wide variations in contemporary clinical... read more

Intravenous Push Levetiracetam Safety in a Neuro-Spine ICU

Intravenous Push Levetiracetam Safety in a Neuro-Spine ICU

Administration of levetiracetam doses up to 2000 mg via IVP is a safe method of administration that results in a reduction of time to medication administration and a reduction of benzodiazepine use. Of the 2,055 hospital-wide... read more

Hospitals With and Without Neurosurgery: Evaluating TBI Patients Outcomes

Hospitals With and Without Neurosurgery: Evaluating TBI Patients Outcomes

In our study, centralization of TBI patients significantly impacted short- and long-term outcomes. For TBI patients admitted to no-NSH centers, our results suggest that the least critically ill can effectively be managed... read more