Focus on Clinical Trial Interpretation

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

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

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

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

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

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 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

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

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 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

Fixing Hypernatremia: Acting Fast or Acting Slow?

Fixing Hypernatremia: Acting Fast or Acting Slow?

This is the largest adult cohort study focusing on the neurologic complications and mortality after hypernatremia correction in critically ill adults. There wasn't any evidence that rapid correction of hypernatremia was... read more

Guidelines for the Management of Severe TBI

Guidelines for the Management of Severe TBI

Often, the available evidence is not sufficient to generate guidelines addressing the most critical questions faced by clinicians and patients. Although there have been some major developments in severe traumatic brain... read more

Prognostic Value of Spreading Depolarizations in Patients With Severe TBI

Prognostic Value of Spreading Depolarizations in Patients With Severe TBI

In this cohort study of patients with acute brain trauma, spreading depolarizations were predominant but heterogeneous and independently associated with poor neurologic recovery. Monitoring the occurrence of spreading depolarizations... read more

Tailoring Nutrition Therapy to Illness and Recovery

Tailoring Nutrition Therapy to Illness and Recovery

Without doubt, in medicine as in life, one size does not fit all. We do not administer the same drug or dose to every patient at all times, so why then would we live under the illusion that we should give the same nutrition... read more

New Hope for Concussions TBI & PTSD

New Hope for Concussions TBI & PTSD

Dr. Larry Komer and Joan Chandler Komer offer new hope to those with brain injuries. Millions of people of all ages experience concussions. Many others have a more serious event known as a traumatic brain injury. Battlefield... read more

Stress Management Intervention to Prevent PICS-Family in Patients’ Spouses

Stress Management Intervention to Prevent PICS-Family in Patients’ Spouses

Sensation Awareness Focused Training (SĀF-T) intervention during the ICU stay is feasible, acceptable, and may improve family caregivers' post-ICU outcomes. Larger clinical trial to assess the effectiveness of SĀF-T in... read more

Is Tranexamic Acid Going to CRASH the Management of TBI?

Is Tranexamic Acid Going to CRASH the Management of TBI?

In the recent CRASH-3 randomized trial, early administration of tranexamic acid (TXA) was associated with a non-significant reduction of head injury-related 28-day mortality in patients with isolated traumatic brain injury... read more