Vasoactive Medication and Randomized Clinical Trials

Vasoactive medication is one of the cornerstones in the treatment of critically ill patients in shock. Shock can be defined as a failure of the circulatory system to provide adequate tissue perfusion resulting in cellular... read more

Clinical Assessment of Critically Ill Patients by Whole-body Ultrasonography

Critical care ultrasonography (CCUS) is increasingly advocated and used, and is defined as point-of-care image acquisition, interpretation and clinical application, all performed by the critical care clinician, and directed... read more

Oxygen Treatment in Intensive Care and Emergency Medicine

Hypoxemia should certainly be avoided, but the fact that the liberal administration of oxygen to patients in intensive care units and emergency rooms tends to increase morbidity and mortality implies the advisability of a... read more

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

Causes and Consequences of Optimistic Expectations About Prognosis by Surrogate Decision-Makers in ICUs

This multicenter study shows that optimistic expectations about prognosis are prevalent among surrogates of patients with advanced critical illness, arise both from misunderstandings by surrogates and from surrogates holding... read more

Mechanical Circulatory Support Devices in Cardiogenic Shock and Acute Heart Failure

Randomized, controlled trials are utterly needed to guide treatment with mechanical circulatory support for patients with cardiogenic shock. Importantly, such trials should focus patient selection criteria. In recent years,... read more

Sedation and Analgesia Impact On Long-term Cognitive Dysfunction in Critical Care Survivors

Deep sedation during stay in the Intensive Care Unit (ICU) may have deleterious effects upon the clinical and cognitive outcomes of critically ill patients undergoing mechanical ventilation. Over the last decade a vast... read more

Hydration for Infants with Bronchiolitis

Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospital admission. Hydration is a mainstay of treatment, but insufficient evidence exists to guide clinical practice.... read more

Detection, Treatment of Dyspnea Inconsistent in ICU

Although the prevalence of dyspnea was at least as high as that of pain, the detection and treatment of moderate to severe dyspnea were more inconsistent than for pain among critically ill patients in the ICU, according to... read more

Adjunctive Corticosteroid Treatment in Septic Shock

Interest in the role of the adrenal cortex in the recovery from an infection dates back nearly 100 yr. More than six decades of research on the role of corticosteroid supplementation as an adjunctive treatment for sepsis... read more

Implications of Heterogeneity of Treatment Effect for Reporting and Analysis of Randomized Trials in Critical Care

Randomized clinical trials (RCTs) are conducted to guide clinicians' selection of therapies for individual patients. Currently, RCTs in critical care often report an overall mean effect and selected individual subgroups.... read more

Crisis Management in Acute Care Settings

Crisis Management in Acute Care Settings: Human Factors and Team Psychology in a High-Stakes Environment is unique in providing a comprehensive overview of the human factors issues relevant to patient safety during acute... read more

Crisis Management in Acute Care Settings

More Precise Sepsis Therapy with Distinct Clinical Phenotypes

In this retrospective analysis of data sets from patients with sepsis, 4 clinical phenotypes were identified that correlated with host-response patterns and clinical outcomes, and simulations suggested these phenotypes may... read more

Antipsychotics to Treat Delirium in Hospitalized Patients Not Including the ICUs

No evidence has been found to support or refute the suggestion that antipsychotics shorten the course of delirium in hospitalized patients. Based on the available studies, antipsychotics do not reduce the severity of delirium... read more

Out-of-Hospital Cardiac Arrest Survivors Need Cardiological and Neurological Rehabilitation

Most survivors of out-of-hospital cardiac arrest (OHCA) suffer from cardiologic symptoms and approximately half of them experience cognitive problems because of hypoxic brain damage. Symptoms of anxiety and depression... read more

What should we stop doing in the ICU?

Intensive care is an interesting specialty. From all the early excitement in the 1970s, passing through two decades of intensive physiological use at the bedside, intensive care landed on the rough ground of modern randomized... read more

Management of Cardiogenic Shock

Cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction although mortality could be reduced from formerly ∼80% to 40–50%. In addition to percutaneous coronary intervention... read more

The negative effect of initial high-dose methylprednisolone and tapering regimen for ARDS

The efficacy of corticosteroid use in acute respiratory distress syndrome (ARDS) remains controversial. Generally, short-term high-dose corticosteroid therapy is considered to be ineffective in ARDS. On the other hand, low-dose,... read more

Long-term Health Consequences of Under- and Over-feeding in PICU

Energy is essential for the treatment and recovery of children admitted to Pediatric Intensive Care Units (PICU). There are significant immediate and long-term health consequences of both under- and over-feeding in this population.... read more

Clustering Algorithms Usage in Critical Care Research Unravel Patient Heterogeneity

Critically ill patients constitute the most heterogeneous population in the hospital, with the highest rates of acute and chronic multi-morbidity. Daily, two critically ill patients are admitted to the ICU with the same... read more

Clinical Impact and Assessment Tools Capable of Identifying Delirium in Cardiac Arrest Survivors

This review aims to describe the clinical impact and assessment tools capable of identifying delirium in cardiac arrest survivors and providing strategies aimed at preventing and treating delirium. Patient factors leading... read more

Age and Decisions to Limit Life Support for Patients with ALI

The purpose of this study was to estimate the association between patient age and the rate of new limitations in the use of life support, independent of daily organ dysfunction status, following acute lung injury (ALI) onset. 490... read more