Outcomes of Patients Requiring Prolonged Acute vs. Short-Term Mechanical Ventilation

Outcomes of Patients Requiring Prolonged Acute vs. Short-Term Mechanical Ventilation

Over one-third of all hospitalized patients on mechanical ventilation require it for greater than or equal to 4 days. Prolonged acute mechanical ventilation patients exhibit a higher burden of both chronic and acute illness... read more

Angiotensin II in Post Cardiopulmonary Bypass Vasoplegia

Angiotensin II in Post Cardiopulmonary Bypass Vasoplegia

Post cardiopulmonary bypass vasoplegia is common, and associated with poor outcomes. Traditional management strategies involving escalating doses of catecholamines, vasopressin and adjuncts such as methylene blue and hydroxycobalamin... read more

Physiologic Assessment: Variation in Fluid and Vasopressor Use in Shock

Physiologic Assessment: Variation in Fluid and Vasopressor Use in Shock

The decision whether to give more fluid during the management of shock can be somewhat provider-dependent. This multicenter prospective cohort study evaluated 1639 patients with hypotension requiring vasopressors. The... read more

Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock

Cost Analysis of Adjunctive Hydrocortisone Therapy for Septic Shock

Using adjunctive hydrocortisone therapy yields a significant monetized benefit based on inputs from the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock and Activated Protein C and Corticosteroids... read more

Factors Associated With Death in Critically Ill Patients With COVID-19 in the US

Factors Associated With Death in Critically Ill Patients With COVID-19 in the US

This study identified demographic, clinical, and hospital-level risk factors that may be associated with death in critically ill patients with COVID-19 and can facilitate the identification of medications and supportive therapies... read more

Therapeutic Alternatives and Strategies for Drug Conservation in the ICU During Times of Drug Shortage

Therapeutic Alternatives and Strategies for Drug Conservation in the ICU During Times of Drug Shortage

During the coronavirus disease (COVID-19) global pandemic, urgent strategies to alleviate shortages are required. Evaluation of the feasibility, practicality, and value of drug conservation strategies and therapeutic alternatives... read more

An Evidence-Based Approach to Pressors in Shock

An Evidence-Based Approach to Pressors in Shock

The evaluation and treatment of patients with cardiovascular shock is a cornerstone of emergency care. Unfortunately, the literature behind the use of vasoactive medications in cardiovascular shock is inconsistent. A Cochrane... read more

Implantation of Impella CP LV Assist Device Under the Guidance of 3D Intracardiac Echocardiography

Implantation of Impella CP LV Assist Device Under the Guidance of 3D Intracardiac Echocardiography

This translational study in ovine model confirms that three-dimensional intracardiac echocardiography is a feasible option to guide implantation of the Impella CP® for left ventricular mechanical support and should be considered... read more

Broad Spectrum Vasopressors

Broad Spectrum Vasopressors

We propose the notion of "broad spectrum vasopressors" wherein patients with septic shock are started on multiple vasopressors with a different mechanism of action simultaneously while the vasopressor sensitivity is assessed.... read more

Epinephrine Challenge in Sepsis: An Empiric Approach to Catecholamines

Epinephrine Challenge in Sepsis: An Empiric Approach to Catecholamines

The critical care world is obsessed with fluid. Meanwhile, little attention has been given to the concepts of vasopressor responsiveness and vasopressor challenge. This is a missed opportunity, because vasopressor challenges... read more

Effect of Vitamin C and Thiamine on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock

Effect of Vitamin C and Thiamine on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock

A 2020 randomized trial reported no difference in duration of time alive and free of vasopressor administration at 7 days among intensive care unit (ICU) patients with septic shock assigned to vitamin C, thiamine, and hydrocortisone... read more

Coronavirus (2019-nCoV): Evidence Relevant to Critical Care

Coronavirus (2019-nCoV): Evidence Relevant to Critical Care

The 2019 Coronavirus outbreak was declared a global Public Health Emergency by the World Health Organization (WHO) on 30th January 2020. In order to ensure immediate access to relevant systematic reviews, this Cochrane... read more

Influence of Head-of-bed Elevation on the Measurement of IVC Diameter and Collapsibility

Influence of Head-of-bed Elevation on the Measurement of IVC Diameter and Collapsibility

In a population of critically ill patients undergoing goal-directed ultrasound examinations, elevating head-of-bed (HOB) to 30° did not significantly alter inferior vena cava (IVC) measurements or CI. At 45°, however,... read more

Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock

Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock

In patients with septic shock, treatment with intravenous vitamin C, hydrocortisone, and thiamine, compared with intravenous hydrocortisone alone, did not significantly improve the duration of time alive and free of vasopressor... read more