A Randomised Trial of High-flow Nasal Cannula in Infants with Moderate Bronchiolitis

In patients with moderate bronchiolitis, there was no evidence of lower rate of escalating respiratory support among those receiving HFNC therapy. The analyses included 268 patients among the 2621 infants assessed for... read more

Anaphylatoxin C5a Impairs Phagocytosis by Neutrophils

This study provides new insight into the mechanisms underlying immunocompromise in critical illness and suggests novel avenues for therapy and prevention of nosocomial infection. Critically ill patients are at heightened... read more

Massive PE with Intra-hospital Cardiac Arrest and Full Recovery of RV Function after vaECMO

The concept of vaECMO treatment alone might be a valuable alternative in selected patients with massive PE and cardiogenic shock, in whom thrombolytic therapy might not unload the RV fast enough. We present a case of a... read more

Endovascular Therapy for Acute Ischemic Stroke During COVID-19 Pandemic

The evaluation and treatment of acute large vessel occlusion stroke present many challenges during the COVID-19 era. It may be difficult to screen stroke patients for COVID-19 symptoms because of encephalopathy or aphasia.... read more

Inhaled Pulmonary Vasodilators

Confusion between inhaled versus intravenous routes for pulmonary vasodilators. For optimal clinical benefit (especially regarding oxygenation), these agents must be given via an inhaled route. The misconception that inhaled... read more

Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock

Using adjunctive hydrocortisone therapy yields a significant monetized benefit based on inputs from the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock and Activated Protein C and Corticosteroids... read more

Approach to New Fever or Rigors in the ICU Patient

Failure to recognize neutropenic fever as a separate entity that requires immediate treatment. Routinely ordering urinalysis and sputum cultures (for most patients, this will only lead to false-positive results and unnecessary... read more

Harm of IV High-Dose Vitamin C Therapy in Adult Patients

There is no consistent evidence that IV high-dose vitamin C therapy is more harmful than placebo in double-blind randomized controlled trials. However, reports of oxalate nephropathy, hypernatremia, glucometer error, and... read more

High Risk of Thrombosis in Patients With Severe SARS-CoV-2 Infection

Despite anticoagulation, a high number of patients with ARDS secondary to COVID-19 developed life-threatening thrombotic complications. Higher anticoagulation targets than in usual critically ill patients should therefore... read more

Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe COVID-19

Among patients with severe or life-threatening COVID-19, convalescent plasma therapy added to standard treatment, compared with standard treatment alone, did not result in a statistically significant improvement in time to... read more

Common Steroid Reduces Deaths Among Patients with Severe COVID-19

A cheap, readily available steroid drug reduced deaths by a third in patients hospitalized with Covid-19 in a large study, the first time a therapy has been shown to possibly improve the odds of survival with the condition... read more

Innovative Approaches to Patient Rehabilitation Maximize COVID-19 Recovery

People hospitalized with COVID-19 can experience debilitating physical changes — extreme fatigue, difficulty breathing and muscle weakness, says April Pruski, M.D., a Johns Hopkins physiatrist (a medical doctor who specializes... read more

Spotting the Clotting: Hypercoagulopathy in COVID-19

Evolving experience with TEG, clotting parameters, treatment considerations, and ongoing data gathering will help us better understand if antiplatelet therapy with aspirin or clopidogrel or anticoagulant treatment with traditional... read more

Rescue Therapy for Severe COVID-19 Associated ARDS with tPA

The COVID-19 pandemic has led to unprecedented stresses on modern medical systems, overwhelming the resource infrastructure in numerous countries while presenting a unique series of pathophysiologic clinical findings. Thrombotic... read more

International PICU COVID-19 Collaboration Conference Call

This episode is an international collaborative conference call hosted by Dr. Jeffrey Burns of Boston Children's Hospital and Harvard Medical School. Featured speakers are Drs. Daniel Barouch, Trevor Duke, and Robinder Khemani,... read more

Implantation of Impella CP LV Assist Device Under the Guidance of 3D Intracardiac Echocardiography

This translational study in ovine model confirms that three-dimensional intracardiac echocardiography is a feasible option to guide implantation of the Impella CP® for left ventricular mechanical support and should be considered... read more

Enteral Fluid Resuscitation? The WHO to the rescue in the ED/ICU?

Prior to the 1970's, restricting oral intake was a "cornerstone" therapy of diarrheal illness, due to the pervasive belief that the GI tract needed time to heal and recover before resuming normal function. This was felt... read more

New Study Showing CBD Strains Lower Chances of COVID-19

With the rapidly growing pandemic of COVID-19 caused by the new and challenging to treat zoonotic SARS-CoV2 coronavirus, there is an urgent need for new therapies and prevention strategies that can help curtail disease spread... read more

Pathological Inflammation in Patients with COVID-19

The COVID-19 pandemic caused by infection with SARS-CoV-2 has led to more than 200,000 deaths worldwide. Several studies have now established that the hyperinflammatory response induced by SARS-CoV-2 is a major cause of disease... read more

Use of High Flow Oxygen Therapy Devices During the COVID-19 Epidemic

Medicines & Healthcare Products Regulatory Agency (MHRA) released a Central Alerting System (CAS) notice about the risk of a sudden pressure drop in oxygen supply pipes if demand through multiple wall outlets exceeds the... read more

Humanizing the ICU Experience with Enhanced Communication

Decisions to limit therapy (DTLT) are routine for ICU physicians. Although breaking bad news is one of the most difficult tasks clinicians face, ongoing communication is even more crucial as families (not necessary following... read more

Recognition, Assessment, and Pharmacotherapeutic Treatment of Alcohol Withdrawal Syndrome in the ICU

Alcohol withdrawal syndrome (AWS) is a complex neurologic disorder that develops after an acute reduction in or cessation of chronic alcohol consumption that alters neurotransmitter conduction. The incidence of AWS in the... read more