Sedation with Midazolam After Cardiac Surgery in Children with and without Down Syndrome

Sedation with Midazolam After Cardiac Surgery in Children with and without Down Syndrome

The majority of children with and without Down syndrome required additional sedation after cardiac surgery. This pharmacokinetic and pharmacodynamic analysis does not provide evidence for different dosing of midazolam in... read more

Effect of Infusion Set Replacement Intervals on Catheter-related Bloodstream Infections

Effect of Infusion Set Replacement Intervals on Catheter-related Bloodstream Infections

The optimal duration of infusion set use to prevent life-threatening catheter-related bloodstream infection (CRBSI) is unclear. We aimed to compare the effectiveness and costs of 7-day (intervention) versus 4-day (control)... read more

Mortality Outcomes with Hydroxychloroquine and Chloroquine in COVID-19 Patients

Mortality Outcomes with Hydroxychloroquine and Chloroquine in COVID-19 Patients

Substantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aim to estimate... read more

Individualized vs. Fixed Positive End-expiratory Pressure for Intraoperative Mechanical Ventilation in Obese Patients

Individualized vs. Fixed Positive End-expiratory Pressure for Intraoperative Mechanical Ventilation in Obese Patients

This secondary analysis of obese patients undergoing laparoscopic surgery found better oxygenation, lower driving pressures, and redistribution of ventilation toward dependent lung areas measured by electrical impedance tomography... read more

A Controlled Trial of Methylprednisolone in COVID-19 Pneumonia

A Controlled Trial of Methylprednisolone in COVID-19 Pneumonia

The use of corticosteroids in patients with pneumonia secondary to COVID-19 has been a controversially hot topic, particularly early on in the pandemic. Prior evidence seen in Severe Acute Respiratory Syndrome (SARS) and... read more

Guidelines on Myocardial Infarction, Novel Therapeutic Targets in Post-infarction Remodelling

Guidelines on Myocardial Infarction, Novel Therapeutic Targets in Post-infarction Remodelling

This Focus Issue on ischaemic heart disease contains the ‘2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management... read more

Comparison of Two Delayed Strategies for RRT initiation for severe AKI

Comparison of Two Delayed Strategies for RRT initiation for severe AKI

Delaying renal replacement therapy (RRT) for some time in critically ill patients with severe acute kidney injury (AKI) and no severe complication is safe and allows optimisation of the use of medical devices. Major uncertainty... read more

Replacement of Fentanyl Infusion by Enteral Methadone Decreases the Weaning Time From Mechanical Ventilation

Replacement of Fentanyl Infusion by Enteral Methadone Decreases the Weaning Time From Mechanical Ventilation

The introduction of enteral methadone during weaning from sedation and analgesia in mechanically ventilated patients resulted in a decrease in the weaning time from mechanical ventilation (MV). A double-blind randomized... read more

Increase in PI during PLR detects a positive response of the PLR test

Increase in PI during PLR detects a positive response of the PLR test

An increase in perfusion index (PI) during passive leg raising (PLR) by 9% accurately detects a positive response of the PLR test. Three patients were excluded because the plethysmography signal was absent and 3 other... read more

SARS-CoV Replication-transcription Complex Can Initiate RNA Synthesis

SARS-CoV Replication-transcription Complex Can Initiate RNA Synthesis

How viruses from the Coronaviridae family initiate viral RNA synthesis is unknown. Here we show that the SARS-CoV-1 and −2 Nidovirus RdRp-Associated Nucleotidyltransferase (NiRAN) domain on nsp12 uridylates the viral cofactor... read more

Haloperidol and Quetiapine for the Treatment of ICU-Associated Delirium in a Tertiary Pediatric ICU

Haloperidol and Quetiapine for the Treatment of ICU-Associated Delirium in a Tertiary Pediatric ICU

In our small, single-center study, patients treated with haloperidol or quetiapine showed no short-term improvement in delirium screening scores after starting treatment when compared with untreated, propensity score-matched... read more

Apremilast Not Likely to Reduce Time to Recovery or Mortality in Critically Ill Patients in I-SPY COVID-19 Trial

Apremilast Not Likely to Reduce Time to Recovery or Mortality in Critically Ill Patients in I-SPY COVID-19 Trial

Quantum Leap Healthcare Collaborative (QLHC), the sponsor of the I-SPY COVID Trial, announced that apremilast (Otezla), made by Amgen, has been dropped for futility. Apremilast was chosen for testing in the I-SPY COVID Trial... read more

The Bougie as an Airway Savior

The Bougie as an Airway Savior

Ever since the BEAM (Bougie Use in Emergency Airway Management) trial was published in JAMA in 2018, the use of the bougie has become increasingly mainstream. Some of the advantages of using a bougie are known, but there... read more

Bridging the Gap Between Intensivists and Primary Care Clinicians in ECMO for Respiratory Failure in Children

Bridging the Gap Between Intensivists and Primary Care Clinicians in ECMO for Respiratory Failure in Children

All pediatric clinicians should be aware not only of the potential benefits and complications of ECMO but also that survivors need effective screening, support, and follow-up. The 2009 influenza A(H1N1) pandemic, along... read more

Early sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial

Early sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial

In critically ill mechanically ventilated patients, early sedation with dexmedetomidine exhibited a high probability of reduced 90-day mortality in older patients regardless of operative or non-operative cluster status. Conversely,... read more

Convalescent Plasma Doesn’t Prevent Further COVID-19 Progression in At-Risk Patients

Convalescent Plasma Doesn’t Prevent Further COVID-19 Progression in At-Risk Patients

Convalescent plasma (CP) from recovered patients with COVID-19 doesn't prevent further COVID-19 progression in at-risk people who visit the emergency room (ER). Early this week, the National Institutes of Health (NIH)... read more

Safety and Efficacy of B-Cell Depletion with Rituximab for the Treatment of SSc-PAH

Safety and Efficacy of B-Cell Depletion with Rituximab for the Treatment of SSc-PAH

B cell depletion therapy is a potentially effective and safe adjuvant treatment for systemic sclerosis-pulmonary arterial hypertension (SSc-PAH). Future studies in these patients can confirm whether the identified biomarkers... read more