Large Decreases in ICU-Acquired Infections - National Infection Campaign ICUs in the UK have seen an 80% drop in bloodstream infections according to NIHR Guy's and St Thomas' Biomedical Research Centre-funded research. In collaboration with Guy's and St Thomas' clinicians and researchers from ICNARC (Intensive Care National Audit & Research Centre), the study analysed 1 million adult patients from 276 NHS ICUs across the UK from 2007-2012. Published in ...

Energy Balance in Obese, Mechanically Ventilated Patients in ICU Clinical evidence shows that overfeeding critically ill patients is associated with poor outcomes. Obesity is a major challenge in ICU patients because of the comorbidities and anomalies associated with it. Determining an appropriate dose of enteral nutrition is difficult in this patient population and the risk of overfeeding quite high. An association between negative energy balance and increased inf...

Noninvasive Ventilation in Early Stage Mild ARDS A recent study assessed the ability of early noninvasive ventilation (NIV) intervention to decrease the need for invasive ventilation in patients with mild forms of acute respiratory distress syndrome (ARDS). This method has already proved successful for acute respiratory failure patients but has not been tested in ARDS. Use of NIV in ARDS patients has been highly debated, especially in cases of mild pneumonia-induce...

ICU Management & Practice, Volume 17 - Issue 4, 2017 Molecular diagnostics in severe respiratory virus infection Recent trends in virus detection assays and host response biomarkers This article provides an overview of the recent advances in molecular testing for patients with suspected respiratory tract infection. Respiratory tract infections are common reasons for admission to intensive care units. For decades conventional culture techniques were th...

CORRESPONDENCE| VOLUME 7, ISSUE 10, PE31, OCTOBER 01, 2019 Secondary re-analysis of the FEAST trial – Authors' reply Michael Levin, Aubrey J Cunnington, Clive J Hoggart Lancet Respir Med 2019; 7: e31 DOI:https://doi.org/10.1016/S2213-2600(19)30264-4 Kathyrn Maitland and colleagues have voiced concerns about the difference between findings in our re-analysis of the FEAST trial1 and their 2013 report2 on which one of us (ML) was also an author. T...

#LIVES2019: Vitamin C for Sepsis Dr. Alpha A. Fowler of Virginia Commonwealth University presented findings from the CITRIS-ALI trial that studied the role of vitamin C in patients with septic ARDS. The findings were presented @ESICM in Berlin and have just been published in JAMA. The CITRIS-ALI randomised trial addressed the use of high dose intravenous vitamin C to study the effects of organ failure and the effects of vitamin C on inflammation and vascular inj...

CORRESPONDENCE| VOLUME 7, ISSUE 10, OCTOBER 01, 2019 Secondary re-analysis of the FEAST trial Kathryn Maitland, Diana M Gibb, Abdel Babiker Lancet Respir Med 2019; 7: e29 DOI:https://doi.org/10.1016/S2213-2600(19)30272-3 The article by Michael Levin and colleagues1 rekindles the discussion about adverse effects of boluses in children with febrile illness and shock, as reported in the FEAST trial.2 However, unfortunately, results of this re-analysis of FEAST da...

#LIVES2019: Findings from the TOPMAST Study In an interesting session at #LIVES2019, Dr. Niels Van Regenmortel from Antwerp University Hospital, Belgium, presented findings from the TOPMAST trial. The TOPMAST study was conducted to determine the effects of sodium content of maintenance fluid therapy on cumulative fluid balance and electrolyte disorders. Dr. Van Regenmortel started off his presentation by discussing five inconvenient truths of recognition that in...

COMMENT| VOLUME 7, ISSUE 10, P830-831, OCTOBER 01, 2019 A new frontier in ARDS trials: phenotyping before randomisation Carolyn M Hendrickson, Carolyn S Calfee Lancet Respir Med 2019; 7: 830-831 DOI:https://doi.org/10.1016/S2213-2600(19)30175-4 Despite decades of progress in both the experimental understanding of acute respiratory distress syndrome (ARDS) and in preclinical studies identifying potentially effective new treatments, most clinical ...

Editorial October 2, 2019 A Measured Dose of Optimism for the Evolution of ICU-Based Palliative Care Christopher E. Cox, MD, May Hua, David Casarett JAMA. Published online October 2, 2019. doi:10.1001/jama.2019.12660 Ideally, palliative care is involved early in the course of illness, and usually in the outpatient setting. With this model of care, the treatment provided is guided by shared decision-making that includes the patient’s voice and a ...