Procalcitonin Reduces Antibiotic Use with No Negative Outcomes

Procalcitonin Reduces Antibiotic Use with No Negative Outcomes

The elderly patient presenting to the ED with nonspecific symptoms remains a diagnostic and therapeutic challenge. Often, these patients arrive with general complaints ranging from altered mental status to weakness, subjective... read more

Catheter Directed Thrombolysis for Intermediate Risk Pulmonary Embolism

Catheter Directed Thrombolysis for Intermediate Risk Pulmonary Embolism

Intermediate risk pulmonary embolism is common and carries a risk of progression to hemodynamic collapse and death. Catheter directed thrombolysis is an increasingly utilized treatment option, based largely on the assumptions... read more

Antibiotic timing in Severe Sepsis

Antibiotic timing in Severe Sepsis

Severe sepsis is a time dependent condition and this study builds on previous literature which supports that early identification and treatment of sepsis with antibiotics decreases mortality. Retrospective analysis of a large... read more

Number Needed to Treat

Number Needed to Treat

Effectively communicating clinical trial results to patients and clinicians is a requirement for appropriate application in clinical practice. In a recent issue of JAMA, Zhao et al1 reported the results from a randomized... read more

Prehospital Intravenous Fentanyl Administered by Ambulance Personnel

Prehospital Intravenous Fentanyl Administered by Ambulance Personnel

Prehospital acute pain is a frequent symptom that is often inadequately managed. The concerns of opioid induced side effects are well-founded. To ensure patient safety, ambulance personnel are therefore provided with treatment... read more

Hypertriglyceridemic pancreatitis: Can we defuse the bomb?

Hypertriglyceridemic pancreatitis: Can we defuse the bomb?

Hypertriglyceridemia causes ~9% of pancreatitis, the third most common cause after alcohol and gallstones. It is a risk factor for severe pancreatitis, making it more frequent among ICU patients with pancreatitis. I see... read more

Antifungal Treatment in the ICU

Antifungal Treatment in the ICU

Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in critically ill patients. Almost 80% of IFIs are due to Candida spp., which are the third most common isolated microorganisms in the intensive... read more

Electrophysiological Investigations of Peripheral Nerves and Muscles

Electrophysiological Investigations of Peripheral Nerves and Muscles

Resting trans-membrane potential difference (Em) of skeletal muscle is correlated to the energy status of the organism: the more severe the illness, the lower the Em. In 1971, Cunningham demonstrated this association with... read more

Hoopla Aside, hs-cTnI is Not Catching Missed Mis

Hoopla Aside, hs-cTnI is Not Catching Missed Mis

We have been searching for a tool to identify myocardial infarction patients who are truly safe for discharge ever since Pope, et al., found that we were discharging two percent of patients with MIs from the emergency department.... read more

Aid Tool Does Not Help Care Decisions in Prolonged Mechanical Ventilation

Aid Tool Does Not Help Care Decisions in Prolonged Mechanical Ventilation

Treatment decisions commonly have to be made in intensive care units (ICUs). These decisions are difficult for surrogate decision makers and often lead to decisional conflict, psychological distress, and treatments misaligned... read more

The Artificial Intelligence Clinician Learns Optimal Treatment Strategies for Sepsis in Intensive Care

The Artificial Intelligence Clinician Learns Optimal Treatment Strategies for Sepsis in Intensive Care

Sepsis is the third leading cause of death worldwide and the main cause of mortality in hospitals but the best treatment strategy remains uncertain. In particular, evidence suggests that current practices in the administration... read more

Optimizing Patient and Family Education Resources for the ICU

Optimizing Patient and Family Education Resources for the ICU

Offering stronger patient and family education tools in the ICU will ease patient and caregiver fears and make them more comfortable with the care setting. An integrated, centralized, and digital platform is best suited for... read more

Metabolic Sepsis Resuscitation

Metabolic Sepsis Resuscitation

There are roughly two strategies for adjusting the intensity of treatment: Titrated strategy: Treatment intensity is adjusted to match the severity of the disease. Escalation-deescalation strategy: Treatment intensity is... read more

Procedure Eases Complications Related to Fluid Around Lungs

Procedure Eases Complications Related to Fluid Around Lungs

As people live longer with more advanced stages of cancer or chronic diseases, the longer their complications must be treated. That can include pleural effusions, an unusually large amount of fluid around a person’s lungs... read more