Treatment of High Intracranial Pressure After Traumatic Brain Injury One of the most frequent causes of death and disability after severe traumatic brain injury (TBI) is high intracranial pressure (ICP). ICP is generally treated with usual techniques such as normothermia, sedation, etc. and first-line therapeutic strategies such as moderate hypocapnia, mannitol etc. However, in patients where these measures do not work, second-line therapies are usually initiated. ...

Original Investigation February 17, 2020 Effect of Intravenous Interferon β-1a on Death and Days Free From Mechanical Ventilation Among Patients With Moderate to Severe Acute Respiratory Distress Syndrome: A Randomized Clinical Trial V. Marco Ranieri,  Ville Pettilä, Matti K. Karvonen, et al JAMA. Published online February 17, 2020. doi:10.1001/jama.2019.22525 Abstract Importance Acute respiratory distress syndrome (ARDS) is associated wit...

ICU Management & Practice, Volume 19 - Issue 3, 2019 Challenges in the Management of the Critically Ill Patient Interview with Massimo Antonelli, Professor of Intensive Care and Anaesthesiology, Università Cattolica del Sacro Cuore, Rome, Italy Massimo Antonelli is a Professor of Intensive Care and Anesthesiology at the Università Cattolica del Sacro Cuore, Rome, Italy. He serves as the Director of the Dept. of Anesthesiology and Intensive Care and ...

In-line Filtration Reduces Organ Dysfunction, Inflammation Patients admitted to the intensive care unit are administered drugs, fluid, and blood products intravenously. In the vast majority of these patients, there are no untoward effects of the intravenous infusion. However, young children and neonates who are ill are usually administered intravenous infusions with the use of in-line filters. The philosophy behind this approach is that the filters may not only block/f...

Using Biomarkers for Mortality Prediction in Patients With Sepsis Sepsis has always carried high mortality. Even today, with all the latest technology and newer antibiotics, sepsis continues to be a major risk factor for death. It is important to understand that the earlier sepsis is diagnosed and treated, the better the prognosis. Each year, nearly 6 million people die of sepsis in the US.  Because of its aggressive course, sepsis  necessitates early diagnosis and imm...

ORIGINAL ARTICLE A Randomized Trial of Erythropoietin for Neuroprotection in Preterm Infants Sandra E. Juul, Bryan A. Comstock, Rajan Wadhawan, et al N Engl J Med 2020; 382:233-243DOI: 10.1056/NEJMoa1907423 BACKGROUND High-dose erythropoietin has been shown to have a neuroprotective effect in preclinical models of neonatal brain injury, and phase 2 trials have suggested possible efficacy; however, the benefits and safety of this therapy in extremely preterm...

ONLINE FIRST (FREE ACCESS)  Editorial ~ Joannidis M et al.- 10 myths about frusemide Conference reports and expert panel ~ Hawryluk G W J et al.- A management algorithm for patients with intracranial pressure monitoring: the Seattle   International Severe Traumatic Brain Injury Consensus Conference (SIBICC). Conference reports and expert panels. What's New in Intensive Care ~ SilversidesJet al.-&nbs...

ICU Management & Practice, Volume 19 - Issue 3, 2019 New Trends in ICU Nutrition The new trends in nutrition management included in the last guidelines are discussed, in particular the route and the dose of calories and proteins recommended. During the last decade, numerous paradigms and dogmas based on observational cohort studies were challenged by the publication of large multicentre prospective randomised controlled trials (RCT). Actually, until rece...

ORIGINAL ARTICLE |FREE PREVIEW Soluble Urokinase Receptor and Acute Kidney Injury Salim S. Hayek, David E. Leaf, Ayman Samman Tahhan, et al N Engl J Med 2020; 382:416-426DOI: 10.1056/NEJMoa1911481 Abstract BACKGROUND Acute kidney injury is common, with a major effect on morbidity and health care utilization. Soluble urokinase plasminogen activator receptor (suPAR) is a signaling glycoprotein thought to be involved in the pathogenesis of kidney disease. W...

Machine Learning to Predict Severe Sepsis and Septic Shock Sepsis is a major cause of death among hospitalised patients. It affects nearly 6% of all admissions and results in in-hospital mortality of greater than 15%. Early detection could reduce mortality, as it would result in the timely implementation of evidence-based interventions.  Clinical researchers have developed and implemented a machine-learning algorithm to predict severe sepsis and septic shock. The go...