Traumatic Brain Injury: Evidence for Delayed Withdrawal of Life-Sustaining Treatment In ICU Mon, 20 May 2024 Each year, over five million people worldwide suffer severe traumatic brain injuries (TBI), with predicting recovery being challenging due to various factors. Families often face the decision to continue or withdraw life-sustaining treatment (WLST), typically within 72 hours post-injury, often based on clinicians' prognosis. However, this decisi...

Expiratory Flow Limitation During Mechanical Ventilation In ICU Wed, 22 May 2024 Expiratory flow limitation (EFL) occurs when the expiratory flow cannot increase despite higher driving pressure at a given lung volume. In airway disease patients, this can happen during tidal expiration (tidal EFL - EFLT). The prevalence of EFLT in intubated patients varies with population, PEEP settings, and detection methods, with up to one-third of mechanically ventil...

COMMENT|ONLINE FIRST Protecting the blood donor: ferritin-based intervals to improve donor health Laura Infanti Lancet Published: June 13, 2024 DOI: https://doi.org/10.1016/S0140-6736(24)01212-1 Strict eligibility criteria and the ageing of the general population are among the main factors limiting blood donor availability,1 and render the retention of experienced donors and the acquisition of new volunteers a demanding task. Also, a temporary inability to ...

Intravenous Landiolol: Rate Control in Supraventricular Tachyarrhythmias in Patients with LVD In ICU Fri, 17 May 2024 ICU Management & Practice, Volume 24 - Issue 3, 2024 Athina Nasoufidou Second Department of Cardiology Aristotle University of Thessaloniki Hippokration General Hospital Thessaloniki, Greece A systematic review investigating landiolol's efficacy in non-septic or post-operated SVT patients with concomitant left ventricular...

ASTER Trial: Acetaminophen and Organ Dysfunction in Patients With Sepsis In Sepsis Wed, 22 May 2024 Acetaminophen (paracetamol) has several pharmacological effects that are potentially beneficial in sepsis, including analgesia, antipyresis, and cyclooxygenase-2 inhibition. Observational studies and small clinical trials suggest acetaminophen improves survival and kidney function in sepsis patients with elevated cell-free haemoglobin. However, a&nb...

COMMENT|ONLINE FIRST Global Burden of Disease Study 2021 estimates: implications for health policy and research Zachary J Ward, Sue J Goldie Lancet Published: April 17, 2024 DOI: https://doi.org/10.1016/S0140-6736(24)00812-2 Over the past three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has produced several iterations of global estimates for various disease metrics.1 The latest iteration, GBD 2021, published in ...

Editorial  June 10, 2024 Anesthesia Dose and Delirium—A Picture Coming Into Focus Miles Berger, Mark D. Neuman JAMA. Published online June 10, 2024. doi:10.1001/jama.2023.26819 In this issue of JAMA,1 Deschamps and colleagues report results of the Electroencephalographic Guidance of Anesthesia to Alleviate Geriatric Syndromes-Canada (ENGAGES-Canada) trial. ENGAGES-Canada compared rates of postoperative delirium among 1140 patients 6...

Specialty Emergency Departments - The Future of Emergency Care? In ICU Tue, 14 May 2024 Specialised emergency departments (EDs) are emerging, focusing on specific patient populations such as oncologic, geriatric, or orthopaedic cases. Advocates argue that these specialised centres can provide more targeted and cost-effective care. They may alleviate pressure on general EDs while potentially improving overall...

Invited Commentary  February 21, 2024 Surgical Site Infections—Time to Test Cost-Effective Prevention Strategies? Jeffrey S. Upperman, Eunice Y. Huang JAMA Surg. 2024;159(5):492. doi:10.1001/jamasurg.2023.7979 The recent randomized clinical trial by Mueller et al1 assessing the effectiveness of polyhexanide 0.04% solution in surgical site infection (SSI) prevention following laparotomy presents findings that challenge established clinical pract...

Past, Present, and Future of Sustainable Intensive Care In ICU Tue, 14 May 2024 Climate change is a critical challenge of the 21st century, with fossil fuel combustion being the largest contributor, responsible for over 75% of greenhouse gas (GHG) emissions. The global healthcare industry significantly impacts the environment, accounting for up to 5% of global carbon emissions, with the U.S. contributing the largest share. Nations with high c...