Remodeling ICU Care

Remodeling ICU Care

A new study finding that two antipsychotics were no more effective than placebo for delirium in critical illness spurs discussion about alternative methods for managing that care. Neither haloperidol nor ziprasidone — both... read more

Decontaminants Don’t Cut Bloodstream Infection Risk in Ventilated ICU Patients

Decontaminants Don’t Cut Bloodstream Infection Risk in Ventilated ICU Patients

The use of digestive and oral decontaminants in patients in the intensive care unit (ICU) who are mechanically ventilated and who have moderate to high antibiotic resistance is not associated with a reduction in ICU-acquired... read more

Vitamin Treatment For Sepsis Is Put To The Test

Vitamin Treatment For Sepsis Is Put To The Test

Dr. Jonathan Sevransky was intrigued when he heard that a well-known physician in Virginia had reported remarkable results from a simple treatment for sepsis. Could the leading cause of death in hospitals really be treated... read more

Drone Doctors

Drone Doctors

Trials in Australia could be signalling the way ahead for a new role for remotely piloted aircraft in the air medical sphere, as James Paul Wallis reports. Drones have long since proved their worth as an aerial search tool... read more

The Effectiveness of Non-Pharmacological Interventions in Reducing the Incidence and Duration of Delirium in Critically Ill Patients

The Effectiveness of Non-Pharmacological Interventions in Reducing the Incidence and Duration of Delirium in Critically Ill Patients

Current evidence does not support the use of non-pharmacological interventions in reducing incidence and duration of delirium in critically ill patients. Future research should consider well-designed and well-described multicomponent... read more

A Multicentre Randomised Controlled Trial of Levetiracetam vs. Phenytoin for Convulsive Status Epilepticus in Children

A Multicentre Randomised Controlled Trial of Levetiracetam vs. Phenytoin for Convulsive Status Epilepticus in Children

Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines,... read more

Delirium in Critical Illness: Haloperidol vs Ziprasidone?

Delirium in Critical Illness: Haloperidol vs Ziprasidone?

Delirium is defined as an acute disorder of consciousness which can occur in up to 80% of mechanically ventilated ICU patients. This acute cognitive dysfunction is associated with prolonged hospital stay, increased mortality,... read more

Cost-effectiveness of Procalcitonin Testing to Guide Antibiotic Treatment Duration in Critically Ill Patients

Cost-effectiveness of Procalcitonin Testing to Guide Antibiotic Treatment Duration in Critically Ill Patients

Although the impact of PCT guidance on total healthcare-related costs during the initial hospitalisation episode is likely negligible, the lower in-hospital mortality may lead to a non-significant increase in costs over a... read more

Septic Shock: Innovative Treatment Options in the Wings

Septic Shock: Innovative Treatment Options in the Wings

Vitamin C, angiotensin-II, and methylene blue are emerging options on the cutting edge of refractory septic shock treatment that require more investigation, but nevertheless appear promising, Rishi Rattan, MD, said at the... read more

Caffeine Accelerates Emergence from Isoflurane Anesthesia in Humans

Caffeine Accelerates Emergence from Isoflurane Anesthesia in Humans

Intravenous caffeine is able to accelerate emergence from isoflurane anesthesia in healthy males without any apparent adverse effects. All randomized participants were included in the analysis. The mean time to emergence... read more

Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient?

Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient?

In this multicentre study, we could not demonstrate any difference between Lp299 and CHX used in oral care procedures regarding their impact on colonisation with emerging potentially pathogenic enteric bacteria in the oropharynx... read more

No more antipsychotics for delirium? Not so fast!

No more antipsychotics for delirium? Not so fast!

Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness. Before jumping into the results of this study, it will help to establish a couple of foundational principles.... read more

The Impact of Frailty on ICU Outcomes

The Impact of Frailty on ICU Outcomes

Functional status and chronic health status are important baseline characteristics of critically ill patients. The assessment of frailty on admission to the intensive care unit (ICU) may provide objective, prognostic information... read more

Angiotensin converting enzyme defects in shock: implications for future therapy

Angiotensin converting enzyme defects in shock: implications for future therapy

Patients who develop vasodilatory shock, particularly when caused by an inflammatory condition like sepsis or pancreatitis, have evidence of significant endothelial injury as manifested by coagulation disorders and increased... read more