Quetiapine Decreases Mortality and Improve Neurological Outcomes in Critically-ill TBI Patients

Quetiapine may decrease mortality and improve neurological outcomes in critically-ill traumatic brain injury (TBI) patients. It has a dose-dependent effect to decrease intracranial pressure (ICP) and increase cerebral perfusion... read more

Computer Tomographic Assessment of Gastric Volume in Major Trauma Patients

In major trauma patients, overall stomach volume deriving from food, fluids and air must be expected to be around 400–500 mL. Gastric dilation caused by air is common but not typically associated with pre-hospital airway... read more

Intracerebral Hemorrhage (ICH)

For most patients, the best treatment seems to be high-quality supportive care. Aggressive interventions (e.g., causing dramatic drops in blood pressure and "prophylactic" hypertonic saline) may cause more harm than good. Cerebellar... read more

Haloperidol for Treatment of Headache in the ED

Headache is a common chief complaint that emergency physicians encounter almost every day and sometimes multiple times in each shift. In fact, headache is the fifth leading cause of patients presenting to the emergency department... read more

TOP KNIFE: The Art & Craft of Trauma Surgery

A practical guide to operative trauma surgery for residents and registrars, for general surgeons with an interest in trauma, and for isolated surgeons operating on wounded patients in military, rural or humanitarian settings.... read more

TOP KNIFE: The Art & Craft of Trauma Surgery

Hydrocortisone Prevents Immunosuppression by interleukin-10+ Natural Killer Cells After Trauma-Hemorrhage

These data demonstrate that trauma-induced immunosuppression is characterized by an interleukin-10-dependent elimination of dendritic cell by natural killer cells and that hydrocortisone improves outcome by limiting this... read more

Translational simulation for rapid transformation of health services, using the example of the COVID-19 pandemic preparation

Healthcare simulation has significant potential for helping health services to deal with the COVID-19 pandemic. Rapid changes to care pathways and processes needed for protection of staff and patients may be facilitated by... read more

Phenotypic Heterogeneity by Site of Infection in Surgical Sepsis

There are notable differences in baseline predisposition, host responses, and clinical outcomes by site of infection in surgical sepsis. While previous studies have focused on differences in hospital mortality, this study... read more

Prevention and Treatment of ALI with Time-controlled Adaptive Ventilation

Neither the current lung protect and rest nor open lung approach (OLA) ventilation strategies have been effective at reducing VILI and ARDS-related mortality below that in the ARMA study. For a protective ventilation strategy... read more

50 Studies Every Intensivist Should Know

50 Studies Every Intensivist Should Know presents key studies that have shaped the practice of critical care medicine. Selected using a rigorous methodology, the studies cover topics including: sedation and analgesia, resuscitation,... read more

50 Studies Every Intensivist Should Know

Big Data to Help Predict Individual Trauma Patient Outcome

Chinese researchers are using big data to help identify trauma patients who could experience potential adverse health events in the emergency department through the aid of a clinical decision support system. It was developed... read more

How COVID-19 is Affecting Trauma Systems in Italy

Italy is the first Western nation to experience the full impact of coronavirus disease. The pandemic is stretching the country's ability to care for older adults and patients with serious underlying medical conditions. But... read more

Focus on Clinical Trial Interpretation

In a recently published meta-epidemiological study of 604 randomised clinical trials (RCTs) published between 1977 and 2018 from 53 Cochrane systematic reviews in critical care, less than 7% of the RCTs had overall low risk... read more

Guidelines for Burn Care Under Austere Conditions

The principles of care after disasters and mass casualty incidents are centered on doing the greatest good for the greatest number. From an airway and ventilation perspective, we have presented the issues that are likely... read more

Validation of Neuromuscular Blocking Agent Use in ARDS

The use of Neuromuscular Blocking Agents (NMBA) could significantly decrease mortality in moderate-to-severe acute respiratory distress syndrome (ARDS) patients and decrease the incidence of barotrauma during mechanical ventilation.... read more

Survivorship Will Be the Defining Challenge of Critical Care in the 21st Century

Distracted by the high mortality rate of critical illness, we tend to overlook the essential fact that most patients survive the intensive care unit (ICU). Every year, millions of patients are discharged from the ICU... read more

eFAST Performance with a Novel vs. Conventional Transducers

Point-of-injury extended focused assessment with sonography in trauma (eFAST) may identify life-threatening torso hemorrhage and expedite casualty evacuation. The purpose of this study was to compare combat medic eFAST performance... read more

Tranexamic Acid in TBI – CRASH-3 Trial Treatment

The CRASH-3 trial is a multi-centre, randomised, placebo-controlled trial of the effects of tranexamic acid on death and disability in patients with traumatic brain injury (TBI). Patients with reactive pupils and/or mild... read more

Epinephrine During Resuscitation of Traumatic Cardiac Arrest and Increased Mortality

Epinephrine administered during in-hospital resuscitation was associated with lower 7-day survival rate in patients with out-of-hospital cardiac arrest (OHCA) following trauma. While we examined the outcomes of selected... read more

Tranexamic Acid Has Nominal Benefit for TBI

Studies examining the use of tranexamic acid (TXA) inescapably seem to pit our rigorous methodological demons against our practical clinical angels. The CRASH-2 trial randomized 20,211 adult trauma patients presenting... read more

Early Psychological Screening of ICU Survivors

Symptoms of post-traumatic stress, anxiety and depression assessed 1 week after ICU stay correlate with 3-month psychological outcome. The HADS and PTSS-10 may be useful aids to identify ICU survivors at high risk for... read more

ICU Bouncebacks Associated with Worse Outcomes

ICU Bouncebacks (ICUBBs) are associated with worse outcomes and are disproportionately burdened by respiratory complications. These findings emphasize the importance of the TQIP Collaborative in identifying statewide... read more