Tele-ICU Leads to Overall Reduction in ICU Mortality

A new systematic review and meta-analysis has found that implementation of tele-ICU services was associated with an overall reduction in ICU mortality. Furthermore, in subgroup analysis, the pooled odds ratio for ICU mortality... read more

Tele-ICU Leads to Overall Reduction in ICU Mortality

This Minimally Invasive Technique Could Reduce the Need for Open-Heart Surgery

Currently, the majority of individuals who undergo transcather aortic valve replacement (TAVR), a minimally invasive alternative to open-heart surgery—are elderly or subject to compounding complications such as kidney disease.... read more

This Minimally Invasive Technique Could Reduce the Need for Open-Heart Surgery

A Non-Antibiotic Approach for Treating or Preventing Sepsis

Researchers at the Royal College of Surgeons in Ireland (RCSI) have tested a compound called cilengitide in a preclinical trial. The drug goes by the brand name InnovoSep. Researchers discover the drug has the potential to... read more

A Non-Antibiotic Approach for Treating or Preventing Sepsis

Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation

In patients presenting to the emergency department with recent-onset, symptomatic atrial fibrillation, a wait-and-see approach was noninferior to early cardioversion in achieving a return to sinus rhythm at 4 weeks. The presence... read more

Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation

Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance

Among patients with E coli or K pneumoniae bloodstream infection and ceftriaxone resistance, definitive treatment with piperacillin-tazobactam compared with meropenem did not result in a noninferior 30-day mortality. These... read more

Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance

Opioid-Induced Respiratory Depression Risk Prediction Tool

Ludwig H. Lin, MD, and Ashish K. Khanna, MD, FCCP, FCCM, discuss Dr. Khanna's top-rated abstract, Derivation and Validation of a Novel Opioid-Induced Respiratory Depression Risk Prediction Tool, from the Society of Critical... read more

Opioid-Induced Respiratory Depression Risk Prediction Tool

The CAM-ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU

The CAM-ICU-7 delirium severity scale is a valid, reliable, and practical delirium severity measure among ICU patients that can be easily calculated and is associated with meaningful clinical outcomes. This practical tool... read more

The CAM-ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU

Sepsis Test Could Show Results In Minutes

A new rapid test for earlier diagnosis of sepsis is being developed by University of Strathclyde researchers. The device, which has been tested in a laboratory, may be capable of producing results in two-and-a-half minutes,... read more

Sepsis Test Could Show Results In Minutes

Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery

Among older patients undergoing cardiac surgery, postoperative scheduled IV acetaminophen, combined with IV propofol or dexmedetomidine, reduced in-hospital delirium vs placebo. Additional research, including comparison of... read more

Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults

Among critically ill adults undergoing tracheal intubation, patients receiving bag-mask ventilation had higher oxygen saturations and a lower incidence of severe hypoxemia than those receiving no ventilation. Among the 401... read more

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults

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

Catheter Directed Thrombolysis for Intermediate Risk Pulmonary Embolism

The PreVent Trial, Assessing the Role of Bag-mask Ventilation During Tracheal Intubation in Critically Ill Adults

In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Dr. Matthew Semler. They discuss the PreVent trial, a recent publication in the 2019 issue of the NEJM that assessed the role of bag-mask... read more

The PreVent Trial, Assessing the Role of Bag-mask Ventilation During Tracheal Intubation in Critically Ill Adults

Fever Control in Critically Ill Adults

One potential way to protect patients from the physiological demands that are a consequence of fever is to aim to prevent fever and to treat it assiduously when it occurs. Our findings do not support the hypothesis that more... read more

Fever Control in Critically Ill Adults

Hospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness

The Hospital Elder Life Program is effective in reducing incidence of delirium and rate of falls, with a trend toward decreasing length of stay and preventing institutionalization. With ongoing efforts in continuous program... read more

Hospital Elder Life Program: Systematic Review and Meta-analysis of Effectiveness

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

Number Needed to Treat

Catheter-Directed Therapy for PE Built on Fallacy

Tissue plasminogen activator has a notoriously checkered past within emergency medicine, and its controversial use continues with the advent of targeted therapy for pulmonary embolism. Catheter-directed administration of... read more

Catheter-Directed Therapy for PE Built on Fallacy

Effect of high-flow nasal cannula oxygen therapy in adults with acute hypoxemic respiratory failure

Conflicting recommendations exist on whether high-flow nasal cannula (HFNC) oxygen therapy should be administered to adult patients in critical care with acute hypoxemic respiratory failure. We performed a meta-analysis of... read more

Effect of high-flow nasal cannula oxygen therapy in adults with acute hypoxemic respiratory failure

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

Hoopla Aside, hs-cTnI is Not Catching Missed Mis

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

Aid Tool Does Not Help Care Decisions in Prolonged Mechanical Ventilation

The Effect of Defining COPD by the Lower Limit of Normal of FEV1/FVC Ratio in TIOSPIR Participants

Using the lower limit of normal to define airflow obstruction would have excluded patients in TIOtropium Safety and Performance In Respimat study with a higher risk of nonfatal major adverse cardiovascular events and a lower... read more

The Effect of Defining COPD by the Lower Limit of Normal of FEV1/FVC Ratio in TIOSPIR Participants

Patient-important outcomes in randomized controlled trials in critically ill patients

Patient-important outcomes are rarely primary outcomes in RCTs in critically ill patients published in 2013. Among them, mortality accounted for the majority. We promote the use of patient-important outcomes in critical care... read more

Patient-important outcomes in randomized controlled trials in critically ill patients