Tag: treatment
Immunotherapy Effects on Sepsis
A randomised controlled multicentre trial assessed for the first time the safety and pharmacokinetics of an antiprogrammed cell death-ligand 1 (anti–PD-L1) immune checkpoint inhibitor (BMS-936559; Bristol-Myers Squibb,... read more
Lactate-Guided Resuscitation Only Encourages Over-Resuscitation and Downstream Harms
The Centers for Medicare and Medicaid Services and the Surviving Sepsis Campaign both rushed to offer guidance on the appropriate management strategies for patients presenting with septic shock. In both cases, a lactate-guided... read more
Prognostic Accuracy of the Serum Lactate Level, the SOFA Score and the qSOFA Score for Mortality Among Adults with Sepsis
Sepsis is a common critical condition caused by the body’s overwhelming response to certain infective agents. Many biomarkers, including the serum lactate level, have been used for sepsis diagnosis and guiding treatment.... read more
High-flow Oxygen Through Nasal Cannula in Acute Hypoxemic Respiratory Failure
In patients with nonhypercapnic acute hypoxemic respiratory failure, treatment with high-flow oxygen, standard oxygen, or noninvasive ventilation did not result in significantly different intubation rates. There was a significant... read more
Optimizing Ceftolozane-tazobactam Dosage in Critically Ill Patients During Continuous Venovenous Hemodiafiltration
Ceftolozane-tazobactam (C/T), the combination of a new cephalosporin with a classic β-lactamase inhibitor, is currently considered the most active betalactam antibiotic against P. aeruginosa. Despite several case reports... read more
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
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
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
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
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
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
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
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
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
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
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
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
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