In-Hospital Cardiac Arrest

In-hospital cardiac arrest is common and associated with a high mortality rate. Despite this, in-hospital cardiac arrest has received little attention compared with other high-risk cardiovascular conditions, such as stroke,... read more

In-Hospital Cardiac Arrest

Why Most Diagnostic Procedures Aren’t Beneficial

We often assume that diagnostic procedures will help patients. A lot of training goes into learning how to do these procedures. Procedures are dramatic. We like performing them. Patients are impressed, perceiving that we... read more

Why Most Diagnostic Procedures Aren’t Beneficial

Loss of Sphingosine 1-Phosphate in Septic Shock is Predominantly Caused by Decreased Levels of HDL

Sphingosine 1-phosphate (S1P) is a signaling lipid essential in regulating processes involved in sepsis pathophysiology, including endothelial permeability and vascular tone. Serum S1P is progressively reduced in sepsis patients... read more

Loss of Sphingosine 1-Phosphate in Septic Shock is Predominantly Caused by Decreased Levels of HDL

Optimizing Beta-Lactam Treatment in the ICU

The French Society of Pharmacology and Therapeutics (SFPT) and the French Society of Anesthesia and Intensive Care Medicine (SFAR) have released guidelines on the optimization of beta-lactam treatment in intensive care unit... read more

Optimizing Beta-Lactam Treatment in the ICU

Neutrophil Extracellular Traps Are Elevated in Patients with Pneumonia-related ARDS

Bronchoalveolar neutrophil extracellular trap concentration was not significantly associated with mechanical ventilation duration in pneumonia-related ARDS. The acute respiratory distress syndrome (ARDS) is the most severe... read more

Neutrophil Extracellular Traps Are Elevated in Patients with Pneumonia-related ARDS

Research Ethics and Informed Consent in Critical Care

Research studies in critically ill populations pose many unique regulatory and ethical challenges that have implications for study design and execution. The life-threatening nature of conditions being studied and the urgency... read more

Research Ethics and Informed Consent in Critical Care

European Guideline on Managing Post-traumatic Bleeding: 5th Edition

An updated guideline on the management of significant bleeding and coagulopathy following major trauma has been released by the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma. The document,... read more

European Guideline on Managing Post-traumatic Bleeding: 5th Edition

Ketamine In Acute and Chronic Pain Management

The view of chronic pain as a symptom of a disease, rather than a disease state itself, has contributed to neglect in treating this condition. Although it is generally acknowledged that patients with chronic pain use significantly... read more

Ketamine In Acute and Chronic Pain Management

Diagnosis and Management of Acute Exacerbations of COPD – Pharmacology CME

As more and more patients present to the ED with symptoms that suggest an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) –worsening dyspnea, cough and sputum production – emergency clinicians can... read more

Diagnosis and Management of Acute Exacerbations of COPD – Pharmacology CME

Noninvasive Ventilation as Acute Therapy

Noninvasive ventilation (NIV) is widely used in ICU patients to treat or to prevent acute respiratory failure (ARF). Whereas its physiological effects are clearly beneficial in hypercapnic patients, it could be deleterious... read more

Noninvasive Ventilation as Acute Therapy

Incidence, Severity, and Detection of Blood Pressure Perturbations after Abdominal Surgery

Intraoperative and postoperative hypotension are associated with myocardial and kidney injury and 30-day mortality. Intraoperative blood pressure is measured frequently, but blood pressure on surgical wards is usually measured... read more

Incidence, Severity, and Detection of Blood Pressure Perturbations after Abdominal Surgery

Updates and Controversies in the Early Management of Sepsis and Septic Shock

For patients in the ED who are suspected of having sepsis, swift, effective management is vital to improving outcomes. This issue reviews the latest evidence on the diagnosis and treatment of sepsis and septic shock: ... read more

Updates and Controversies in the Early Management of Sepsis and Septic Shock

Clostridium difficile infection in the ICU

About 10% of patients with diarrhea will test positive for CDI. Around 2% of ICU patients develop an episode of CDI. Estimating the severity of CDI is essential for prognosis and therapy. Diagnosis and estimation of disease... read more

Clostridium difficile infection in the ICU

Threshold Analysis as an Alternative to GRADE for Assessing Confidence in Guideline Recommendations Based on Network Meta-analyses

Guideline development requires the synthesis of evidence on several treatments of interest, typically by using network meta-analysis (NMA). Because treatment effects may be estimated imprecisely or be based on evidence lacking... read more

Threshold Analysis as an Alternative to GRADE for Assessing Confidence in Guideline Recommendations Based on Network Meta-analyses

Dysphagia in the ICU: Epidemiology, Mechanisms, and Clinical Management

In the light of the fact that the clinical consequences of ICU-acquired dysphagia (e.g., aspiration-induced pneumonitis/pneumonia) can often be observed on ICUs, more data on underlying mechanisms and/or risk factors seems... read more

Dysphagia in the ICU: Epidemiology, Mechanisms, and Clinical Management

Personalization of Arterial Pressure in the Perioperative Period

This review aims to discuss recent findings on the relationship between intraoperative arterial hypotension and organ dysfunction in surgical patients and examines the available evidence for personalizing blood pressure (BP)... read more

Personalization of Arterial Pressure in the Perioperative Period

Ethical Dilemmas in Pediatrics

Children in precarious health present particular problems for healthcare professionals because of their intimate relation to their family, and because of the family's need to provide major long-term source of support and... read more

Ethical Dilemmas in Pediatrics

Determination of Brain Death Under Extracorporeal Life Support

The worldwide use of extracorporeal lung/life support is increasing in severe lung failure (veno-venous extracorporeal membrane oxygenation, vvECMO) or in cardiac arrest/severe circulatory failure (veno-arterial ECMO, vaECMO).... read more

Determination of Brain Death Under Extracorporeal Life Support

Increased Hospital-Based Physical Rehabilitation and Information Provision After ICU Discharge

Post-ICU hospital-based rehabilitation, including increased physical and nutritional therapy plus information provision, did not improve physical recovery or HRQOL, but improved patient satisfaction with many aspects of recovery.... read more

Increased Hospital-Based Physical Rehabilitation and Information Provision After ICU Discharge

Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance

Among patients with E coli or K pneumoniae bloodstream infection and ceftriaxone resistance, definitive treatment with piperacillin-tazobactam compared with meropenem did not result in a noninferior 30-day mortality. These... read more

Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance

Management of Pediatric Severe Traumatic Brain Injury

This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects... read more

Management of Pediatric Severe Traumatic Brain Injury