Rivaroxaban Lowers Cardiovascular Risk But Increases Bleeding Risk

In 27,395 patients with stable atherosclerotic disease, the addition of 2.5 mg rivaroxaban twice daily to aspirin therapy reduced the rates of cardiovascular death, stroke, or nonfatal MI, at the cost of increased major bleeding... read more

Rivaroxaban Lowers Cardiovascular Risk But Increases Bleeding Risk

Helping The ITU Patient Sleep

It is well-known that patients in the intensive care units do suffer from a lack of sleep and frequent sleep disturbances. So how can we help the ITU patient sleep? This is a Cochrane review looking at the efficacy of non-pharmacological... read more

Helping The ITU Patient Sleep

Chloride and Other Electrolyte Concentrations in Commonly Available 5% Albumin Products

This study is the first to identify and document a statistically significant variability in the chloride concentration of available 5% albumin products. This study has also informed a pilot randomized controlled trial examining... read more

Chloride and Other Electrolyte Concentrations in Commonly Available 5% Albumin Products

Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults

The age of transfused red cells did not affect 90-day mortality among critically ill adults. In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest... read more

Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults

Enhancing Recovery From Sepsis

Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. In the... read more

Enhancing Recovery From Sepsis

Central Venous Catheter – Which Needle?

A prospective randomised trial comparing insertion success rate and incidence of catheterisation-related complications for subclavian venous catheterisation using a thin-walled introducer needle or a catheter-over-needle... read more

Central Venous Catheter – Which Needle?

Effect of Standardized Handoff Curriculum on Improved Clinician Preparedness in the ICU

The UW-IPASS standardized handoff curriculum was perceived to improve intensive care provider preparedness and workflow. IPASS-based curricula represent an important step forward in communication standardization efforts and... read more

Effect of Standardized Handoff Curriculum on Improved Clinician Preparedness in the ICU

Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction

Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery. Among patients predominantly undergoing abdominal surgery who... read more

Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction

Effect of Lung Recruitment and Titrated PEEP vs Low PEEP on Mortality in Patients with ARDS

In patients with moderate to severe Acute Respiratory Distress Syndrome (ARDS), a strategy with lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) compared with low PEEP increased 28-day all-cause mortality.... read more

Effect of Lung Recruitment and Titrated PEEP vs Low PEEP on Mortality in Patients with ARDS

Early goal-directed nutrition in ICU patients (EAT-ICU)

Extensive weight loss has been documented in intensive care unit (ICU) survivors, primarily as the result of muscle loss, leading to impaired physical function and reduced quality of life. The aim of the EAT-ICU trial is... read more

Early goal-directed nutrition in ICU patients (EAT-ICU)

Balanced Crystalloids vs Saline for Critically Ill Adults

Among critically ill adults, use of balanced crystalloids for intravenous fluid administration reduced the composite of death, new renal replacement therapy, and persistent renal dysfunction compared with use of saline. Patients... read more

Balanced Crystalloids vs Saline for Critically Ill Adults

Pilot Feasibility Study of Therapeutic Hypothermia for Moderate to Severe ARDS

Neuromuscular blockade alone does not cause hypothermia but allowed acute respiratory distress syndrome patients to be effectively cooled. Results support conducting a randomized clinical trial of hypothermia in acute respiratory... read more

Pilot Feasibility Study of Therapeutic Hypothermia for Moderate to Severe ARDS

Effect of Antibiotic Prophylaxis on Surgical Site Infections Following Removal of Orthopedic Implants

In this randomized clinical trial that included 470 patients who were undergoing surgery for removal of orthopedic implants used for treatment of below-the-knee fractures, surgical site infection occurred in 12.9% of patients... read more

Effect of Antibiotic Prophylaxis on Surgical Site Infections Following Removal of Orthopedic Implants

Top 10 Critical Care Trials for 2017

We held a poll within our editorial group, rating all 36 of the published trials from 2017 that we have summarised and critiqued. We considered the importance of the clinical question, how game changing the conclusion was... read more

Top 10 Critical Care Trials for 2017

The Future of Mechanical Ventilation

The adverse effects of mechanical ventilation in acute respiratory distress syndrome (ARDS) arise from two main causes: unphysiological increases of transpulmonary pressure and unphysiological increases/decreases of pleural... read more

The Future of Mechanical Ventilation

Meta-Analysis Shows Mixed Results with Palliative Care

Palliative care was tied to some improvements in quality of life (QOL) in critically ill patients, but the impact on caregiver outcomes was mixed, and there was no significant association between palliative care delivery... read more

Meta-Analysis Shows Mixed Results with Palliative Care

Guidelines for the Content of Statistical Analysis Plans in Clinical Trials

While guidance on statistical principles for clinical trials exists, there is an absence of guidance covering the required content of statistical analysis plans (SAPs) to support transparency and reproducibility. Recommendations... read more

Guidelines for the Content of Statistical Analysis Plans in Clinical Trials

Treating Acid–Base Abnormalities in the ICU

Acidemia has both harmful and beneficial biological effects. Sodium bicarbonate is generally ineffective in raising pH when ventilation is limited, as in patients with ARDS. Even when alkalinizing agents can correct the pH,... read more

Treating Acid–Base Abnormalities in the ICU