Tag: therapy
Advanced Hemodynamic and Cardiopulmonary Ultrasound for Critically Ill Patients
Focused echocardiography, advanced hemodynamic, and cardiopulmonary point-of-care ultrasound studies provide time-sensitive evaluation of critically ill patients, guiding and facilitating earlier implementation of life-preserving... 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
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
ECMO for Severe Middle East Respiratory Syndrome Coronavirus
Extracorporeal membrane oxygenation (ECMO) use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. The results of this, largest to date, support the use of ECMO as a rescue... read more
Acute Kidney Injury in Sepsis
Acute kidney injury (AKI) and sepsis carry consensus definitions. The simultaneous presence of both identifies septic AKI. Septic AKI is the most common AKI syndrome in ICU and accounts for approximately half of all such... read more
Chloride and Other Electrolyte Concentrations in Commonly Available 5% Albumin Products
This study is the first to identify and document a statistically significant variability in the chloride concentration of available 5% albumin products. This study has also informed a pilot randomized controlled trial examining... read more
The Fallacy of Time-to-Intervention Studies
We are barraged by time-to-intervention studies (door-to-balloon time, time-to-antibiotics, door-to-needle, etc.). However, it must be kept in mind that these studies are purely correlational in design. Such studies cannot... read more
Balanced Crystalloids vs Saline for Critically Ill Adults
Among critically ill adults, use of balanced crystalloids for intravenous fluid administration reduced the composite of death, new renal replacement therapy, and persistent renal dysfunction compared with use of saline. Patients... read more
PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock
In patients who have acute myocardial infarction with cardiogenic shock, early revascularization of the culprit artery by means of percutaneous coronary intervention (PCI) improves outcomes. However, the majority of patients... read more
Hope is a Therapeutic Tool
Everyone who has been a patient, or accompanied a relative to see a doctor, recognises the importance of the doctor-patient relationship. At its heart is the patient's need to understand what is wrong, be understood, and... read more
Is Simvastatin the Miracle Drug We Think It Is?
Evaluation of early administration of simvastatin in the prevention and treatment of delirium in critically ill patients undergoing mechanical ventilation. This well designed and conducted trial demonstrates that there is... read more
Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis
The post-thrombotic syndrome frequently develops in patients with proximal deep-vein thrombosis despite treatment with anticoagulant therapy. Pharmacomechanical catheter-directed thrombolysis (hereafter "pharmacomechanical... read more
I help bring music to patients in intensive care
After my own experience in ICU, I became convinced of the therapeutic benefits of live music to those who are critically ill. Soothing acoustic music drifted through the clinical, high-tech ward. As the professional musician... read more
Corticosteroid Therapy for Critically Ill Patients with the MERS
Corticosteroid therapy in patients with Middle East Respiratory Syndrome (MERS) was not associated with a difference in mortality after adjustment for time-varying confounders, but was associated with delayed MERS coronavirus... read more
Effect of Azithromycin on Asthma Exacerbations and Quality of Life in Adults with Persistent Uncontrolled Asthma
Adults with persistent symptomatic asthma experience fewer asthma exacerbations and improved quality of life when treated with oral azithromycin for 48 weeks. Azithromycin might be a useful add-on therapy in persistent asthma.... read more
Promoting High-Value Practice by Reducing Unnecessary Transfusions With a Patient Blood Management Program
Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing... read more
The Dark Sides of Fluid Administration in the Critically Ill Patient
The administration of intravenous fluids is probably the most frequently initiated therapy in critically ill patients. With very few exceptions, such as severe congestive heart failure, IV fluids are considered as a safe... read more
An Expert Consensus Statement on Physical Rehabilitation After Hospital Discharge
A consensus-based framework for optimal physical therapy (PT) after hospital discharge is proposed. Future research should focus on feasibility testing of this framework, developing risk stratification tools and validating... read more
