Palliative care from diagnosis to death

Evidence is growing that people can benefit from palliative care earlier in their illness, say Scott Murray and colleagues, but care must be tailored to different conditions. Many people still associate palliative care with... read more

The Changing Face of Informed Consent

Informed consent for a research study brings to mind a paper document with a handwritten signature completed at a clinical research site. However, the paper, ink, and clinical site are not necessary. Sufficient information... read more

What’s new with stress ulcer prophylaxis in the ICU?

Critically ill patients are at risk of stress-related mucosal erosions. These are typically superficial and asymptomatic but may progress to ulceration and overt and clinically important gastrointestinal (GI) bleeding,... read more

A Primer on the Perils of Intravenous Fluids – Part 2

Critically-ill patients all likely have endothelial dysfunction to some degree. resuscitationThis perturbation in microvascular physiology may be underpinned by abnormal glycocalyx structure and function. Sepsis, trauma,... read more

Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy

Between June 17, 2014, and July 17, 2016, 660 consecutive patients were randomly assigned to receive no prophylaxis (n=332) or intravenous hydration (n=328). 2–6 day serum creatinine was available for 307 (92%) of 332 patients... read more

Vitamin D supplementation to prevent acute respiratory tract infections

Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit. 25 eligible... read more

POCT for emergency assessment of coagulation in patients treated with direct oral anticoagulants

Hemochron Signature Point-of-care testing (POCT) can be a fast and reliable alternative for guiding emergency treatment during rivaroxaban and dabigatran therapy. It allows the rapid identification of a relevant fraction... read more

Carotid Stenting Technology Has More Appeal

Ten-year follow-up from the CREST trial and 5-year follow-up from the ACT I study, presented at least year's International Stroke Conference, showed that carotid artery stenting (CAS) holds up well over the long term... read more

Candida Auris forms biofilms that enhance its virulence and resistance

In three separate trials, eight samples of each strain of C. auris grew biofilms that constitute a key driver of Candida pathogenicity. C. auris first attracted attention in 2009 because of its resistance to azoles and amphotericin... read more

Blood Thinner Also Effective for Artery Disease

A phase 3 trial evaluating the efficacy and safety of rivaroxaban (Xarelto, Bayer/Janssen), an oral anticoagulant, for the prevention of major adverse cardiac events (MACE) - including cardiovascular death, myocardial infarction,... read more

Interventions to improve antibiotic prescribing practices for hospital inpatients

This review includes 221 studies (58 RCTs, and 163 NRS). Most studies were from North America (96) or Europe (87). The remaining studies were from Asia (19), South America (8), Australia (8), and the East Asia (3). We found... read more

Crizanlizumab use lowers rates of sickle cell crises

Patients with sickle cell disease treated with high-dose crizanlizumab experienced lower annualized rates of sickle cell crisis compared to placebo treatment, regardless of their baseline use of hydroxyurea. Those treated... read more

Thromboprophylaxis after Knee Arthroscopy and Lower-Leg Casting

The results of our trials showed that prophylaxis with low-molecular-weight heparin for the 8 days after knee arthroscopy or during the full period of immobilization due to casting was not effective for the prevention of... read more

Six myths promoted by the new surviving sepsis guidelines

The Rivers trial and the Surviving Sepsis Campaign popularized sepsis protocols, which saved lives. Massive accomplishment. However, that doesn’t validate the individual components of early goal-directed therapy. Any protocol... read more

Benefits and harms of duloxetine for treatment of stress urinary incontinence

Duloxetine was significantly better than placebo in terms of percentage change in weekly incontinence episodes (mean difference - 13.56%, 95% confidence interval [CI] -21.59% to -5.53%) and change in Incontinence Quality... read more

The ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families

Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the... read more

Effects of Video vs Direct Laryngoscopy on Successful Orotracheal Intubation in ICU Patients

Among patients in the ICU requiring intubation, video laryngoscopy compared with direct laryngoscopy did not improve first-pass orotracheal intubation rates and was associated with higher rates of severe life-threatening... read more

Magnet guidance reduces misplacement of subclavian vein catheter in internal jugular vein

The internal jugular vein (IJV) and subclavian vein (SCV) are the two most commonly used insertion sites for central venous catheterization (CVC). A multicenter clinical trial compared commonly used insertion sites and... read more

Better glycemic control with continuous glucose monitoring

This randomized clinical trial compares the effects of continuous glucose monitoring vs conventional treatment for glycemic control in adult patients with type 1 diabetes treated with multiple daily insulin injections.... read more

Liberation from Mechanical Ventilation in Critically Ill Adults

Official Executive Summary of an American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically Ill Adults. The panel provides recommendations... read more

Effect of Omega 3 polyunsaturated fatty acids in major burn patients

The inclusion of ω-3 PUFAs in a low fat diet in ICU burned patients was associated with significant clinical benefits compared to a conventional low fat diet, with lower rates of severe sepsis, septic shock and pyloric dysfunction.... read more

Towards precision medicine for sepsis patients

Over the last decade it has become clear that the immunological response and clinical course in sepsis patients is too complex to simply regard it as hyperinflammation-induced organ failure. In contrast to the previous belief... read more