Should ICU clinicians follow patients after ICU discharge? No

Post-intensive care syndrome (PICS) describes new or worsening impairments of physical, cognitive or mental health resulting from an episode of critical illness and its treatment and lasting after discharge... read more

Should ICU clinicians follow patients after ICU discharge? No

Should ICU clinicians follow patients after ICU discharge? Yes

The trajectory of recovery from critical illness is often portrayed as a continuum. At one extremity lies an unstable patient dependent on life-sustaining treatments in the intensive care unit. At the... read more

Should ICU clinicians follow patients after ICU discharge? Yes

Do phenylephrine and epinephrine require central access?

Until recently I believed that prolonged vasopressor administration requires a central line, to avoid extravasation. I lumped together all vasopressors, treating them all as equal. I used the occurrence of an extravasation... read more

Do phenylephrine and epinephrine require central access?

Haloperidol Serum Concentrations in Critically Ill Patients Included in the REDUCE Study

ICU delirium occurs frequently and is associated with unfavorable outcome. A recent delirium prevention study, the REDUCE study, has assessed the efficacy of prophylactic use of haloperidol. In this subset... read more

Haloperidol Serum Concentrations in Critically Ill Patients Included in the REDUCE Study

Six Reasons to Avoid Fluoroquinolones in the Critically Ill

As an internal medicine resident and pulmonary/critical care fellow, I loved fluoroquinolones. They were effective, easy to prescribe, and had 100% oral bioavailability. However, working full-time in the ICU has forced me... read more

Six Reasons to Avoid Fluoroquinolones in the Critically Ill

Viral Sepsis in Children

Sepsis in children is typically presumed to be bacterial in origin until proven otherwise, but frequently bacterial cultures ultimately return negative. Although the incidence of viral-induced sepsis is not precisely known,... read more

Withdrawing vs. Not Offering Cardiopulmonary Resuscitation: Is There a Difference?

In light of the SCC's Cuthbertson v. Rasouli decision, the distinction between withdrawing and not offering a medical treatment is increasingly relevant. Because CPR is a "default" treatment for cardiac arrest, it requires... read more

High Flow Nasal Oxygen for Acute Bronchiolitis?

Since bronchiolitis is a clinical diagnosis, there is no test, including viral testing and radiography, which rules it in or out (Schuh et al 2007). Sadly, despite multiple guidelines (NICE, AAP, CPS), there has also been... read more

High Flow Nasal Oxygen for Acute Bronchiolitis?

The Needs of Families of Trauma Intensive Care Patients

This mixed methods study identified that families of trauma patients have different needs to families of general patients and the nurses rated the needs of the families of trauma patients as less important than the families... read more

The Needs of Families of Trauma Intensive Care Patients

Hospitals Prepare To Launch Their Own Drug Company To Fight High Prices And Shortages

Shortages of commonplace generic drugs have plagued hospitals in recent years. And with short supplies and fewer suppliers for key drugs, there have been price increases. Hospital purchasing agents keep searching for new... read more

Hospitals Prepare To Launch Their Own Drug Company To Fight High Prices And Shortages

Device Delivers Drugs to the Brain to Stop Seizures

The failure of systemic drug treatments to address numerous neurological disorders has spurred the development of alternative approaches that attempt localized treatment. These localized treatments focus therapy on the region... read more

Device Delivers Drugs to the Brain to Stop Seizures

Lessons From Everest’s Sherpas Could Aid Intensive Care Treatment

A research expedition to Mount Everest has shed light on the unique physiological basis of adaptations seen in the native Sherpa people, which make them better suited to life at high altitude. This improved understanding,... read more

Lessons From Everest’s Sherpas Could Aid Intensive Care Treatment

Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions

From 2008 to 2015, total acute care utilization for the treatment of low-acuity conditions and associated spending per member in the United States increased, and utilization of non-ED acute care venues increased rapidly.... read more

Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions

Time-limited Trial of Intensive Care Treatment

In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition,... read more

Time-limited Trial of Intensive Care Treatment

New antibiotics and antimicrobial combination therapy for the treatment of gram-negative bacterial infections

Only few new molecules have an adequate activity against MDR gram-negative pathogens, especially carbapenemase-producer strains. Among these, ceftozolane/tazobactam has been recently approved for clinical use. Other compounds,... read more

New antibiotics and antimicrobial combination therapy for the treatment of gram-negative bacterial infections

Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation

Among patients with severe secondary mitral regurgitation, the rate of death or unplanned hospitalization for heart failure at 1 year did not differ significantly between patients who underwent percutaneous mitral-valve repair... read more

Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation

It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock

The administration of a continuous infusion of hydrocortisone to a general population of patients in septic shock on mechanical ventilation cannot be recommended at this time. The authors conclusion that glucocorticoids do... read more

It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock

ECMO for Severe ARDS

Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every... read more

ECMO for Severe ARDS