Speed of Cooling After Cardiac Arrest: Sub-study from TTM-2 Trial Out-of-hospital cardiac arrest (OHCA) typically has a poor prognosis. Less than 50% of patients admitted to ICU survive to hospital discharge. Animal models suggest that therapeutic hypothermia is neuroprotective and decreases neuronal injury.  Targeted temperature management (TTM 33–36 °C) is part of international guidelines when managing post-OHCA patients. Evidence suggests that better neu...

Editorial  February 20, 2023 The Ethics of Clinical Research: Managing Persistent Uncertainty Alex John London, Christopher W. Seymour JAMA. Published online February 20, 2023. doi:10.1001/jama.2023.1675 In the face of novel pathogens, incomplete knowledge, and disagreement about the merits of medical treatments, translating the duty to care into concrete benefits for patients depends on our ability to quickly act on the duty to learn.1 ...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Reducing Antibiotic Resistance in the ICU This article reviews practices currently available to reduce the spread of antimicrobial resistance and novel therapies that are presently being developed. Introduction Among healthcare providers, and especially among those working with intensive care unit (ICU) patients, one of the greatest concerns that has emerged in recent decades has been a steady escal...

Editorials Poorly substantiated health claims on infant formula Nigel Rollins BMJ 2023; 380 doi: https://doi.org/10.1136/bmj.p310 (Published 15 February 2023)Cite this as: BMJ 2023;380:p310 Authorities should move to protect infants and parents from commercial interests Early infant feeding is critically important for the survival, development, and lifelong health of children. It is also a big business. In 2019, global sales of infant formula milks exceeded...

Sepsis in Critical Care The importance of clearly defining sepsis, improving early recognition strategy, and increasing the understanding of innate and adaptive immune system derangements that facilitate the development of sepsis. The improvement in mortality outcomes of patients with sepsis is attributable to the early recognition of sepsis, better adherence to guidelines, and a prompt organisation's responsiveness. However, sepsis remains the leading cause of deat...

Barriers to Nurse-Led Pain Management in ICU Approximately 58% of patients in the ICU experience pain. Pain can lead to additional consequences, including delirium, decreased healing and adverse physiological and psychological outcomes. Hence, effective pain management is an integral component of a critical care nurse's role. Commonly used pain assessment tools depend on a patient's ability to communicate. ICU nurses must be capable of assessing pain using behav...

Genome-Wide Association Study of Patients With Sepsis Sepsis is a systemic inflammatory response to infections accompanied by organ dysfunction. Sepsis has a high mortality rate of about 30%. Approximately 189 cases of sepsis per 100,000 people are reported per year. Many genetic studies have identified gene variants associated with the development and outcomes of sepsis.  In this study, the researchers conduct the first genome-wide association study of 28-...

EDITORIAL Improved Prospects for Thrombectomy in Large Ischemic Stroke Pierre Fayad N Engl J Med February 10, 2023DOI: 10.1056/NEJMe2300193 Mechanical endovascular thrombectomy, when performed within 24 hours after the onset of symptoms in patients with small-to-moderate acute ischemic strokes that are due to proximal occlusion of a large cerebral vessel, has been shown to result in rates of recanalization of 70 to 80% and to significantly improve functional i...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Diagnostic Stewardship in Five Common Infectious Syndromes This article defines diagnostic stewardship and discusses how it can be implemented in intensive care units and how it may improve patient outcomes. Introduction Antimicrobial resistance (AMR) is an imminent threat to global health and has been accelerated by the inappropriate use of antimicrobials (Llor and Bjerrum 2014). Antimicrobial stew...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Rapid Diagnostics and Antimicrobial Resistance in the ICU The need to address the problem of antimicrobial resistance, the importance of faster diagnosis of bacterial infections and an overview of rapid diagnostic testing. Antimicrobial resistance (AMR) is rapidly increasing on a global scale. The discovery of penicillin revolutionised the field of medicine, providing safe harbour from the most pressin...