Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients

Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients

In mechanically ventilated patients enrolled in a randomized clinical trial of early mobilization, the use of vasoactive medications was independently associated with the development of ICU-acquired weakness. Prospective... read more

Early Norepinephrine Has Potential for Septic Shock

Early Norepinephrine Has Potential for Septic Shock

Standard sepsis algorithms have suggested completing a fluid bolus before starting vasopressors in patients with septic shock, but multiple observational trials have shown an association between early vasopressor use and... read more

Physical Rehabilitation in the ICU

Physical Rehabilitation in the ICU

Survivors of critical illness frequently experience poor physical outcomes, including persistent impairments in muscle strength, exercise capacity and physical function. In this article, we review these impairments and... read more

Ineffectiveness of Procalcitonin-Guided Antibiotic Therapy in Severely Critically Ill Patients

Ineffectiveness of Procalcitonin-Guided Antibiotic Therapy in Severely Critically Ill Patients

Procalcitonin-guided (PCT) antibiotic therapy fails to decrease the mortality or length of stay (LOS) of critically ill patients with suspected or confirmed sepsis. PCT-guided cessation of antibiotic therapy could reduce... read more

Balanced Crystalloids vs. Saline in Critically Ill Adults

Balanced Crystalloids vs. Saline in Critically Ill Adults

Among critically ill adults, the use of balanced crystalloids for intravenous fluid administration resulted in a lower rate of the composite outcome of death from any cause, new renal-replacement therapy, or persistent renal... read more

Adjunctive Corticosteroid Treatment in Septic Shock

Adjunctive Corticosteroid Treatment in Septic Shock

Interest in the role of the adrenal cortex in the recovery from an infection dates back nearly 100 yr. More than six decades of research on the role of corticosteroid supplementation as an adjunctive treatment for sepsis... read more

Implications of Heterogeneity of Treatment Effect for Reporting and Analysis of Randomized Trials in Critical Care

Implications of Heterogeneity of Treatment Effect for Reporting and Analysis of Randomized Trials in Critical Care

Randomized clinical trials (RCTs) are conducted to guide clinicians' selection of therapies for individual patients. Currently, RCTs in critical care often report an overall mean effect and selected individual subgroups.... read more

More Precise Sepsis Therapy with Distinct Clinical Phenotypes

More Precise Sepsis Therapy with Distinct Clinical Phenotypes

In this retrospective analysis of data sets from patients with sepsis, 4 clinical phenotypes were identified that correlated with host-response patterns and clinical outcomes, and simulations suggested these phenotypes may... read more

A Compression Method to Reduce Fluid Balance of Septic Shock Patients

A Compression Method to Reduce Fluid Balance of Septic Shock Patients

This article presents a close look at the Corporeal Compression at the Onset of Septic shock (COCOONs). Fluid overload in septic intensive care unit (ICU) patients is common and strongly associated with poor outcome. There... read more

Randomized Clinical Trial of an ICU Recovery Pilot Program for Survivors of Critical Illness

Randomized Clinical Trial of an ICU Recovery Pilot Program for Survivors of Critical Illness

This randomized pilot trial found that a multidisciplinary ICU recovery program could deliver more interventions for post ICU recovery than usual care. The finding of longer time-to-readmission with an ICU recovery program... read more

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation

The CABANA Randomized Clinical Trial. In this randomized clinical trial involving 2204 patients with atrial fibrillation, catheter ablation, compared with medical therapy, did not significantly reduce the primary composite... read more

Serum Chloride Levels in Critical Illness – The Hidden Story

Serum Chloride Levels in Critical Illness – The Hidden Story

Chloride is the principal anion of the extracellular fluid and vital for both serum electroneutrality and acid-base homeostasis. The aim of this review is to investigate the relevance of dyschloremia in the critically... read more

What should we stop doing in the ICU?

Intensive care is an interesting specialty. From all the early excitement in the 1970s, passing through two decades of intensive physiological use at the bedside, intensive care landed on the rough ground of modern randomized... read more

Early Goal-directed Therapy Using a Physiological Holistic View

Early Goal-directed Therapy Using a Physiological Holistic View

If peripheral perfusion-targeted resuscitation improves 28-day mortality, this could lead to simplified algorithms, assessing almost in real-time the reperfusion process, and pursuing more physiologically sound objectives.... read more