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

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

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

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

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

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

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

Losing Sleep Over Delirium

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

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

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

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

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

AKI and Mild Therapeutic Hypothermia in Patients After Cardiopulmonary Resuscitation

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

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

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

Abnormal Saline and the History of Intravenous Fluids

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

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

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

Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy

Sepsis patients treated and released from emergency departments do well with outpatient follow-up

National guidelines assume that all patients who're diagnosed with clinical sepsis in an emergency department will be admitted to the hospital for additional care, but new research has found that many more patients are being... read more

Sepsis patients treated and released from emergency departments do well with outpatient follow-up

Early Noninvasive Ventilation and Nonroutine Transfusion for Acute Chest Syndrome in Sickle Cell Disease in Children

Early noninvasive ventilation combined with nonroutine transfusion is well tolerated in acute chest syndrome in children and may spare transfusion in some patients. Early recognition of patients still requiring transfusion... read more

Early Noninvasive Ventilation and Nonroutine Transfusion for Acute Chest Syndrome in Sickle Cell Disease in Children

Getting Creative with Ketamine

Versatile and safe, Ketamine can help with sedation, induction, asthma and pain. Can a shot of it even treat suicidality? New indications for Ketamine seem to be popping up every day. Its primary ED use is for procedural... read more

Getting Creative with Ketamine

Clinical Chronobiology: A Timely Consideration in Critical Care Medicine

Circadian rhythms are currently low on the list of physiological priorities during ICU ward rounds. We have argued that recognition of the influence of this universally important system, and adoption of chronobiological strategies,... read more

Clinical Chronobiology: A Timely Consideration in Critical Care Medicine

A Basic Approach to Treating Various Types of Hypoxia

The use of supplemental oxygen is of no value when treating stagnant and histotoxic hypoxia because the problem is due to impaired cardiac function and cell enzyme inhibition respectfully. Supplemental oxygen is of little... read more

A Basic Approach to Treating Various Types of Hypoxia

Can A Cocktail Of Vitamins And Steroids Cure A Major Killer In Hospitals?

Scientists have launched two large studies to test a medical treatment that, if proven effective, could have an enormous impact on the leading cause of death in American hospitals. The treatment is aimed at sepsis, a condition... read more

Can A Cocktail Of Vitamins And Steroids Cure A Major Killer In Hospitals?

Ketamine Alters Hippocampal Cell Proliferation and Improves Learning in Mice after TBI

Ketamine alters hippocampal cell proliferation after traumatic brain injury (TBI). Surprisingly, these changes were associated with improvement in a neurogenesis-related behavioral recall task, suggesting a possible benefit... read more

Ketamine Alters Hippocampal Cell Proliferation and Improves Learning in Mice after TBI

The Use of Bolus-Dose Vasopressors in the Emergency Department

While bolus-dose vasopressors are commonly used in critical care medicine and anesthesiology to treat patients with hypoperfusion, its application in emergency medicine is minimal with little penetration into daily care.... read more

The Use of Bolus-Dose Vasopressors in the Emergency Department

Adaptive servo ventilation cuts atrial fib burden

Adaptive servo ventilation produced a significant and clinically meaningful reduction in atrial fibrillation burden in patients with heart failure and sleep apnea in results from an exploratory, prospective, randomized study... read more

Adaptive servo ventilation cuts atrial fib burden