Impact of timing of continuous intravenous anesthetic drug treatment on outcome in refractory status epilepticus

Patients with refractory status epilepticus (RSE) treated with continuous intravenous anesthetic drugs (cIVADs) may benefit from early initiation of such therapy. When cIVADs are applied in RSE, prescribing them early... read more

Impact of timing of continuous intravenous anesthetic drug treatment on outcome in refractory status epilepticus

Short-term vs. Conventional Glucocorticoid Therapy in Acute Exacerbations of COPD

In patients presenting to the emergency department with acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD), 5-day treatment with systemic glucocorticoids was noninferior to 14-day treatment with regard to... read more

Short-term vs. Conventional Glucocorticoid Therapy in Acute Exacerbations of COPD

MODS on Day 1 is a Major Source of Mortality in the PICU

Multiple Organ Dysfunction Syndrome (MODS) present on Day 1 of admission continues to be a major source of morbidity and mortality in the PICU, but risk of poor neurologic outcome may be improved. Further research is... read more

MODS on Day 1 is a Major Source of Mortality in the PICU

Assessment of Microcirculation in Cardiogenic Shock

The parameter most frequently used to detect tissue malperfusion is serum lactate. Novel, noninvasive methods to quantify microvascular perfusion have the potential to guide treatment in terms of optimizing organ perfusion... read more

Assessment of Microcirculation in Cardiogenic Shock

CytoSorb Associated with Decreased Observed vs. Expected 28-day All-cause Mortality in ICU Patients with Septic Shock

CytoSorb was associated with a decreased observed versus expected 28-day all-cause mortality. By IPTW analysis, intervention with CytoSorb may be associated with a decreased all-cause mortality at 28 days compared to CRRT... read more

CytoSorb Associated with Decreased Observed vs. Expected 28-day All-cause Mortality in ICU Patients with Septic Shock

Vitamin C for Sepsis Suffers a Setback. Or a Step-Forward. It’s Complicated

The CITRIS-ALI study found no difference in primary outcomes among patients with sepsis treated with vitamin C versus placebo. But there was a difference in a secondary outcome - overall mortality. When it comes to sepsis... read more

Candida Bloodstream Infection Under Veno-arterial ECMO Therapy

Cavayas et al. recently described invasive fungal infections in patients under extra-corporeal membrane oxygenation (ECMO) of the Extracorporeal Life Support Organization registry. They found a 1.2% prevalence of Candida... read more

Candida Bloodstream Infection Under Veno-arterial ECMO Therapy

Epinephrine, Inodilator, or No Inotrope in VA-ECMO Implantation

Early epinephrine therapy within the first 24 h after cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO) was associated with poor survival compared to patients with or without any inodilator therapy.... read more

Epinephrine, Inodilator, or No Inotrope in VA-ECMO Implantation

Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Sepsis

Among patients with severe manifestations of sepsis, initiation of empirical antimicrobial therapy significantly reduces the sensitivity of blood cultures drawn shortly after treatment initiation. Of 3,164 participants... read more

Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Sepsis

Occupational Therapy in the ICU

The role of occupational therapists in ICU rehabilitation is not currently well established. Current interventions in the ICU are dominated by physical rehabilitation with a growing role in communication and delirium... read more

Occupational Therapy in the ICU

Refractory Septic Shock: Our Pragmatic Approach

Despite timely intervention, there exists a small subgroup of patients with septic shock who develop progressive multi-organ failure. Seemingly refractory to conventional therapy, they exhibit a very high mortality. Such... read more

Refractory Septic Shock: Our Pragmatic Approach

Beyond Ventilator-induced Diaphragm Dysfunction

Respiratory muscles are essential to ensure the vital function of breathing. The diaphragm is a unique respiratory muscle, because it contracts throughout the individual's life span without resting, not even during sleep.... read more

Beyond Ventilator-induced Diaphragm Dysfunction

Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients

In mechanically ventilated patients enrolled in a randomized clinical trial of early mobilization, the use of vasoactive medications was independently associated with the development of ICU-acquired weakness. Prospective... read more

Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients

Comparison of Diagnostic Accuracy Among Procalcitonin, C-reactive protein, and Interleukin 6 for Blood Culture Positivity in General ICU Patients

Despite various technological advances, it still usually takes at least 24 to 48 h to obtain a blood culture result. The subsequent delays in diagnosis and treatment of infection can negatively impact care in the intensive... read more

Comparison of Diagnostic Accuracy Among Procalcitonin, C-reactive protein, and Interleukin 6 for Blood Culture Positivity in General ICU Patients

Ineffectiveness of Procalcitonin-Guided Antibiotic Therapy in Severely Critically Ill Patients

Procalcitonin-guided (PCT) antibiotic therapy fails to decrease the mortality or length of stay (LOS) of critically ill patients with suspected or confirmed sepsis. PCT-guided cessation of antibiotic therapy could reduce... read more

Ineffectiveness of Procalcitonin-Guided Antibiotic Therapy in Severely Critically Ill Patients

Balanced Crystalloids vs. Saline in Critically Ill Adults

Among critically ill adults, the use of balanced crystalloids for intravenous fluid administration resulted in a lower rate of the composite outcome of death from any cause, new renal-replacement therapy, or persistent renal... read more

Balanced Crystalloids vs. Saline in Critically Ill Adults

A Compression Method to Reduce Fluid Balance of Septic Shock Patients

This article presents a close look at the Corporeal Compression at the Onset of Septic shock (COCOONs). Fluid overload in septic intensive care unit (ICU) patients is common and strongly associated with poor outcome. There... read more

A Compression Method to Reduce Fluid Balance of Septic Shock Patients

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation

The CABANA Randomized Clinical Trial. In this randomized clinical trial involving 2204 patients with atrial fibrillation, catheter ablation, compared with medical therapy, did not significantly reduce the primary composite... read more

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation