A Randomized Trial of a Family-Support Intervention in ICUs

Family-support intervention in ICUs increased patient comfort and reduced costs. Among critically ill patients and their surrogates, a family-support intervention delivered by the interprofessional ICU team did not significantly... read more

Do We Know Enough to Recommend Corticosteroids in ARDS?

We read with interest the evidence-based recommendations for the use of prolonged corticosteroids in early moderate to severe acute respiratory distress syndrome (ARDS) published in Critical Care Medicine by the Corticosteroid... read more

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

Vasopressors for Hypotensive Shock

This review seeks unbiased evidence about the effects of different drugs that enhance blood pressure on risk of dying in critically ill patients with impaired blood circulation. Review authors identified 28 randomized controlled... read more

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation

In this emergency department, use of a bougie compared with an endotracheal tube + stylet resulted in significantly higher first-attempt intubation success among patients undergoing emergency endotracheal intubation.... read more

Resuscitation Sequence Intubation – Hypoxemia Kills

This blog post is the second part of a series of 3, on a recent lecture I was asked to give on Critical Care Updates: Resuscitation Sequence Intubation. This talk was mostly derived from a podcast by Scott Weingart (Twitter:... read more

Emory Cares for ICU Patients Remotely, Turning “Night into Day” from Australia

A partnership involving Emory Healthcare, Royal Perth Hospital in Australia, along with health technology company, Philips, will move night intensive care work in the Emory eICU Center into daylight hours, focusing on the... read more

Nicorandil Protects Older Patients from Myocardial Injury After PCI

Intravenous nicorandil cut the risk of periprocedural myocardial injury (pMI) after percutaneous coronary intervention (PCI) by 49 percent among patients 65 and older, according to a substudy of a randomized trial published... read more

Best PEEP Trials are Dependent on Tidal Volume

Determining the optimal positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome remains an area of active investigation. Most trials individualizing PEEP optimize one physiologic parameter... read more

Epidemiology of Sepsis in Turkish ICUs

The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms,... read more

Delirium in ICU Prevented With Nocturnal Administration of Dexmedetomidine

Low-dose dexmedetomidine administered at night to critically ill adults reduced the incidence of delirium during intensive care unit (ICU) stays and patient-reported sleep quality remained unchanged, according to a study... read more

Weaning from the Ventilator and Extubation in ICU

Current research is focusing on preventing extubation failure, especially in the most challenging cases. The use of weaning protocols – written or computerized – attempts to early identify patients who are able to breathe... read more

Reducing contamination rates in urine samples

Contamination is thought to be a significant problem. Depending on which study you look at, the rates of urine contamination can be 17% or upwards. The standard method of midstream urine collection is for the healthcare professional... read more

One-Year Outcomes in Patients With ARDS

Poor functional recovery after invasive mechanical ventilation for acute respiratory distress syndrome is common. Helmet noninvasive ventilation may be the first intervention that mitigates the long-term complications that... read more

Incorporating Dynamic Assessment of Fluid Responsiveness Into Goal-Directed Therapy

In adult patients admitted to intensive care who required acute volume resuscitation, goal-directed therapy guided by assessment of fluid responsiveness appears to be associated with reduced mortality, ICU length of stay,... read more

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

Unexplained Mortality Differences Between Septic Shock Trials

Although the definition of septic shock has been standardized, some variation in mortality rates among clinical trials is expected. Insights into the sources of heterogeneity may influence the design and interpretation of... read more

RRT in the Critically Ill Child

Although renal replacement therapy (RRT) is widely used in critically ill children, there have been few comprehensive population-based studies of its use. This article describes renal replacement therapy use, and associated... read more

Ten False Beliefs in Neurocritical Care

1. Only neurointensivists should care about the brain. 2. Clinical examination of neurocritically ill patients is impossible. 3. We should no longer monitor ICP in traumatic brain injury (TBI). 4. The threshold to treat... read more

Papers of the Month March 2018

Gavin Denton and I get together again to review a couple of recent papers that have some bearing on our practice. Welcome to the Papers of the month. This month we cover Check Up- Position- “A Multicenter, Randomized Trial... read more

Apneic Oxygenation in the ICU

Hypoxemia is the most common complication of endotracheal intubation in the critically ill and the strongest risk factor for periprocedural cardiac arrest and death. The traditional approach to avoiding desaturation during... read more

The Efficacy and Safety of Pre-hospital Cooling After Out-of-Hospital Cardiac Arrest

Mild therapeutic hypothermia (TH), or targeted temperature management, improves survival and neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA). International guidelines strongly support initiating... read more