Prehospital Antibiotics Improved Some Aspects of Sepsis Care

Prehospital Antibiotics Improved Some Aspects of Sepsis Care

Training EMS personnel in early recognition of sepsis improved some aspects of care within the acute care chain, but did not reduce mortality, according to results of a randomized trial. Emergency medical service (EMS) personnel... read more

Outcomes in Patients with Vasodilatory Shock and RRT Treated with Intravenous Angiotensin II

Outcomes in Patients with Vasodilatory Shock and RRT Treated with Intravenous Angiotensin II

Acute kidney injury (AKI) requiring renal replacement therapy in severe vasodilatory shock is associated with an unfavorable prognosis. Angiotensin II treatment may help these patients by potentially restoring renal function... read more

Decision-making in the detection and management of patients with sepsis in resource-limited settings

Decision-making in the detection and management of patients with sepsis in resource-limited settings

We read with interest the study by Andrews et al. and the related correspondence from Shrestha et al. We share the concern that clinical examination (and observations) appear(s) to be perceived as relatively unimportant in... read more

Too Much SALT on the ICU?

Too Much SALT on the ICU?

There has a been a little flutter of activity in the #FOAMed world this week about two trials published in the NEJM on the subject of balanced fluids in the care of critically ill patients, and also on admitted patients in... read more

Combined Intravenous Thrombolysis and Thrombectomy vs Thrombectomy Alone for Acute Ischemic Stroke

Combined Intravenous Thrombolysis and Thrombectomy vs Thrombectomy Alone for Acute Ischemic Stroke

The results indicate that treatment of patients experiencing AIS due to a large vessel occlusion with IVT before MT does not appear to provide a clinical benefit over MT alone. A randomized clinical trial seems warranted.... read more

Haloperidol Prophylaxis in Critically Ill Patients with a High Risk for Delirium

Haloperidol Prophylaxis in Critically Ill Patients with a High Risk for Delirium

The use of the delirium prevention protocol seems to result in improvement of several delirium outcome measures. Prophylactic treatment with low dose haloperidol in critically ill patients with a high risk of delirium likely... read more

Pressure Injuries and Sedation: Are they related?

Pressure Injuries and Sedation: Are they related?

Critically ill patients inherently have most of the risk factors for the development of pressure injuries. One of the key factors is immobility, which is very frequent in ICUs. This lack of mobility is enhanced by the administration... read more

Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients

Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients

Does use of the pulmonary embolism rule-out criteria (PERC) in emergency department patients with low clinical probability of pulmonary embolism (PE) safely exclude the diagnosis of PE? Among very low-risk patients with suspected... read more

Bike Rehab is Helping Critical Care Patients Along the Road to Recovery

Bike Rehab is Helping Critical Care Patients Along the Road to Recovery

Getting on the bike is a stepping stone into rehabilitation - you see that bike and you know then that you're getting better. You know you're not just going to lie in that bed and vegetate. So successful was the exercise... read more

Effect of a Multifaceted Performance Feedback Strategy on Length of Stay Compared With Benchmark Reports Alone

Effect of a Multifaceted Performance Feedback Strategy on Length of Stay Compared With Benchmark Reports Alone

In the context of ICUs participating in a national registry, applying a multifaceted activating performance feedback strategy did not lead to better patient outcomes than only receiving periodical registry reports. The extent... read more

An Exploratory Reanalysis of the Randomized Trial on Efficacy of Corticosteroids as Rescue Therapy for the Late Phase of ARDS

An Exploratory Reanalysis of the Randomized Trial on Efficacy of Corticosteroids as Rescue Therapy for the Late Phase of ARDS

During active intervention, methylprednisolone was safe and effective in achieving disease resolution. Our findings support rapid glucocorticoid discontinuation post extubation as likely cause of disease relapse. Gradual... read more

Noninvasive Ventilation in Hypercapnic COPD

Noninvasive Ventilation in Hypercapnic COPD

Recently, Murphy and colleagues reported findings from a clinical trial designed to evaluate the effect of home noninvasive ventilation (NIV) with oxygen on time to readmission or death in patients with persistent hypercapnia... read more

REPROVE: Ceftazidime-avibactam Noninferior to Meropenem for Nosocomial Pneumonia

REPROVE: Ceftazidime-avibactam Noninferior to Meropenem for Nosocomial Pneumonia

Ceftazidime-avibactam was noninferior to meropenem for nosocomial pneumonia including ventilator-associated pneumonia (VAP) from gram-negative organisms, results from the REPROVE trial demonstrated. Nosocomial or hospital-acquired... read more

Is Overall Mortality the Right Composite Endpoint in Clinical Trials of ARDS?

Is Overall Mortality the Right Composite Endpoint in Clinical Trials of ARDS?

Most deaths in acute respiratory distress syndrome (ARDS) patients are not directly related to lung damage but to extrapulmonary multisystem organ failure. It would be challenging to prove that specific lung-directed therapies... read more