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

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

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

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

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

Balanced Crystalloids vs Saline for Critically Ill Adults

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

Pilot Feasibility Study of Therapeutic Hypothermia for Moderate to Severe ARDS

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

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

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

Top 10 Critical Care Trials for 2017

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

The Future of Mechanical Ventilation

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

Meta-Analysis Shows Mixed Results with Palliative Care

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

Guidelines for the Content of Statistical Analysis Plans in Clinical Trials

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

Treating Acid–Base Abnormalities in the ICU

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

Is Simvastatin the Miracle Drug We Think It Is?

Is Simvastatin the Miracle Drug We Think It Is?

Evaluation of early administration of simvastatin in the prevention and treatment of delirium in critically ill patients undergoing mechanical ventilation. This well designed and conducted trial demonstrates that there is... read more

Strategies for the Prevention of Airway Complications

Strategies for the Prevention of Airway Complications

Despite being infrequent, complications of airway management remain an important contributor to morbidity and mortality during anesthesia and care of the critically ill. Developments in the last three decades have made anesthesia... read more

A supplemental intravenous amino acid infusion sustains a positive protein balance for 24 hours in critically ill patients

A supplemental intravenous amino acid infusion sustains a positive protein balance for 24 hours in critically ill patients

Providing supplemental amino acids to ICU patients during a 3-h period results in improved whole-body net protein balance, without an increase in amino acid oxidation. The primary objective was to investigate if a 24-h intravenous... read more