Ten False Beliefs in Neurocritical Care

Ten False Beliefs in Neurocritical Care

1. Only neurointensivists should care about the brain. 2. Clinical examination of neurocritically ill patients is impossible. 3. We should no longer monitor ICP in traumatic brain injury (TBI). 4. The threshold to treat... read more

In ICUs, a Furry Friend to Comfort Patients

In ICUs, a Furry Friend to Comfort Patients

Amid the monitor alarms and life-and-death conversations on the intensive care unit, Tucker, a very mellow Labrador retriever, rolled onto his back at the nurses' station. Delighted staff surrounded the dog, cooing and scratching... read more

Does Respiratory Variation Of Inferior Vena Cava Diameter Predict Fluid Responsiveness In Spontaneously Ventilating Children With Sepsis

Does Respiratory Variation Of Inferior Vena Cava Diameter Predict Fluid Responsiveness In Spontaneously Ventilating Children With Sepsis

IVC collapsibility has poor test characteristics for predicting fluid responsiveness in spontaneously ventilating children with sepsis. Thirty-nine fluid boluses were recorded in 33 children, 28/39 (72%) of which met criteria... read more

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying... read more

Too Much SALT on the ICU?

Too Much SALT on the ICU?

There has a been a little flutter of activity in the #FOAMed world this week about two trials published in the NEJM on the subject of balanced fluids in the care of critically ill patients, and also on admitted patients in... read more

Association Between Continuous Hyperosmolar Therapy and Survival in Patients with TBI

Association Between Continuous Hyperosmolar Therapy and Survival in Patients with TBI

Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared... read more

Haloperidol Prophylaxis in Critically Ill Patients with a High Risk for Delirium

Haloperidol Prophylaxis in Critically Ill Patients with a High Risk for Delirium

The use of the delirium prevention protocol seems to result in improvement of several delirium outcome measures. Prophylactic treatment with low dose haloperidol in critically ill patients with a high risk of delirium likely... read more

Update of a Systematic Review of Autoresuscitation After Cardiac Arrest

Update of a Systematic Review of Autoresuscitation After Cardiac Arrest

Although case reports of autoresuscitation are hampered by variability in observation and monitoring techniques, autoresuscitation has now been reported in adults and children, and there appears to be a distinction in timing... read more

Decision-making on withholding or withdrawing life-support in the ICU

Decision-making on withholding or withdrawing life-support in the ICU

Many critically ill patients who die will do so after a decision has been made to withhold/withdraw life-sustaining therapy. Our objective was to document the characteristics of intensive care unit (ICU) patients with a decision... read more

Noninvasive Ventilation in Hypercapnic COPD

Noninvasive Ventilation in Hypercapnic COPD

Recently, Murphy and colleagues reported findings from a clinical trial designed to evaluate the effect of home noninvasive ventilation (NIV) with oxygen on time to readmission or death in patients with persistent hypercapnia... read more

R.E.B.E.L. EM – Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation

R.E.B.E.L. EM – Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation

Fluid resuscitation is a crucial aspect of emergency and critical care. Since the advent of the concept of early goal-directed therapy, we have placed a huge emphasis on aggressive fluid resuscitation in patients with severe... read more

Music as Therapy in the ICU

Music as Therapy in the ICU

Music has been shown to reduce respiratory, cardiac and blood pressure frequencies in response to the reduction of stress hormones. In a randomized clinical trial, it was shown to reduce anxiety and sedation doses/intervals... read more

Adjuvant Therapies in Critical Care: Music Therapy

Adjuvant Therapies in Critical Care: Music Therapy

Emerging from the perioperative and oncology fields, music therapy (MT) and patient-directed music interventions (PDMI) have recently garnered interest in the area of critical care. The main goal of these music-based adjuvant... read more

Oral Versus Intravenous Antibiotics for the Treatment Of Bone and Joint Infection

Oral Versus Intravenous Antibiotics for the Treatment Of Bone and Joint Infection

Oral antibiotic therapy is non-inferior to IV therapy when used during the first six weeks in the treatment for bone and joint infection, as assessed by definitive treatment failure within one year of randomisation. These... read more