Sepsis is a Preventable Public Health Problem

There is a paradigm shift happening for sepsis. Sepsis is no longer solely conceptualized as problem of individual patients treated in emergency departments and intensive care units but also as one that is addressed as public... read more

Effect of Decompressive Laparotomy on Organ Function in Patients with Abdominal Compartment Syndrome

Decompressive laparotomy has been advised as potential treatment for abdominal compartment syndrome (ACS) when medical management fails; yet, the effect on parameters of organ function differs markedly in the published literature.... read more

Pediatric Sepsis Care Within an Hour Decreases Chance of Death

More than one in 10 children hospitalized with sepsis die, but when a series of clinical treatments and tests is completed within an hour of its detection, the chances of survival increase considerably, according to a new... read more

MAP of 65: Target of the Past?

Septic shock is defined as sepsis with hypotension refractory to fluid challenge and requiring vasopressor support combined with an increase in arterial lactate reflecting impaired cellular energy metabolism and dysoxia.... read more

Vascular Effects of Adrenomedullin and the Anti-Adrenomedullin Antibody Adrecizumab in Sepsis

Sepsis remains a major scientific and medical challenge, for which, apart from significant refinements in supportive therapy, treatment has barely changed over the last few decades. During sepsis, both vascular tone and vascular... read more

Hemophagocytic Lymphohistiocytosis: Potentially Underdiagnosed in ICUs

Overall, 7 out of 9 patients (77.8%) suffering from aHLH remained undiagnosed. Awareness of this life-threatening syndrome, especially in ICUs, should be raised. The inclusion of ferritin into the admission lab panel for... read more

Choice of Fluid Therapy in the Initial Management of Sepsis, Severe Sepsis, and Septic Shock

Sepsis results in disruption of the endothelial glycocalyx layer and damage to the microvasculature, resulting in interstitial accumulation of fluid and subsequently edema. Fluid resuscitation is a mainstay in the initial... read more

Sodium Bicarbonate Therapy for Patients with Severe Metabolic Acidaemia in the ICU

In patients with severe metabolic acidaemia, sodium bicarbonate had no effect on the primary composite outcome. However, sodium bicarbonate decreased the primary composite outcome and day 28 mortality in the a-priori defined... read more

Intracranial Pressure Thresholds in Severe Traumatic Brain Injury: Pro

Teleologically, the mammalian brain has evolved to be the central component of life. It coordinates afferent and efferent neural pathways, integrates neurohormonal responses and, in humans, produces higher cortical effects... read more

Treatment of Acute Non-Anion Gap Metabolic Acidosis

Acute non-anion gap metabolic acidosis is now recognized to be as a common cause of metabolic acidosis, particularly in the ICU. Further examination of its impact on cellular function and clinical outcome are needed. Most... read more

Immunotherapy for Sepsis: A Good Idea or Another Dead End?

THE treatment of sepsis remains an intractable problem in critical care. It has been called the “graveyard”1 for pharmaceutical companies in recognition of dozens of negative clinical trials; this reflects multiple distinct... read more

Warfarin Nonadherence: What Factors Lead Patients with Afib to Discontinue?

Patients with atrial fibrillation (AF) frequently discontinue their warfarin therapy, and a recently-published study offers insight into factors that may contribute to nonadherence. The report, released in JAMA Cardiology,... read more

Sevoflurane for the treatment of refractory status epilepticus in the critical care unit

A 50-year-old woman with liver failure was admitted to critical care for refractory status epilepticus (RSE). Following tracheal intubation, sevoflurane was administered via the MIRUS system (Pall Medical, Dreieich, Germany).... read more

Losing Sleep Over Delirium

Delirium is an acute cognitive disorder that presents with alterations in levels of consciousness accompanied by a change in cognition or perceptual disturbance that develops over a short period (hours to days) and fluctuates... read more

Current efforts to fight sepsis aren’t working. We need a bolder approach

Thanks to antibiotics, vaccinations, and public health advances like modern sanitation, it's easy to think that Americans live largely free of the infectious diseases that once took such a toll. That’s partially right:... read more

Very high intact-protein formula successfully provides protein intake according to nutritional recommendations in overweight critically ill patients

Enteral feeding with VHPF (8 g/100 kcal) resulted in higher protein intake and plasma amino acid concentrations than an isocaloric SHPF (5 g/100 kcal), without an increase in energy intake. This VHPF facilitates feeding according... read more

AKI and Mild Therapeutic Hypothermia in Patients After Cardiopulmonary Resuscitation

The aim of this study was to investigate the influence of mild therapeutic hypothermia (MTH) on the incidence of and recovery from acute kidney injury (AKI). Mild therapeutic hypothermia seems to have a protective effect... read more

Hurt: The Inspiring, Untold Story of Trauma Care

Told through the eyes of a surgeon who has flown on rescue helicopters, resuscitated patients in trauma centers in Houston and Chicago, and operated on hundreds of trauma victims of all ages, Hurt takes us on a tour of the... read more

Hurt: The Inspiring, Untold Story of Trauma Care

FIRST-line Support for Assistance in Breathing in Children (FIRST-ABC)

A multicentre pilot randomised controlled trial of high-flow nasal cannula therapy versus continuous positive airway pressure in pediatric critical care. Our pilot trial confirms that, following minor changes to consent procedures... read more

Abnormal Saline and the History of Intravenous Fluids

Two new clinical trials together involving nearly 30,000 patients support previous observational evidence that the most common solution used for intravenous fluid therapy in the world is associated with kidney damage. Both... read more

Why a terminally ill young woman has changed her mind about living

o face each day, Claire Wineland undergoes hours of breathing treatments. It's a reality of living with cystic fibrosis she's come to accept. But last month, as the nebulizer hummed loudly in her La Jolla, California, hotel... read more

Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy

The 5-year TACTIC project is a multi-component study, a main focus of which is the development of European-wide clinical trial, entitled "Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy... read more