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...

SCCM’s Top 5 of 2019 Concise Critical Appraisals Epinephrine Versus Norepinephrine...Early Sedation Using Dexmedetomidine...Antipsychotic Medications for Delirium...Moderate Therapeutic Hypothermia in...Effect of Low Versus Intermediate Tidal... Critical Connection Articles Wound Care CodingCentral Venous Access Procedures Peripheral Vasopressors: Friend or Foe? The Vasopressor Toolbox for Defending... 2019 Billing and Coding Changes for... iCritical Care P...

Nutritional Support in Malnourished Medical Inpatients Patients who are malnourished or at nutritional risk do tend to have poorer outcomes compared to patients who are relatively healthier when they undergo surgery or are sick. Poorly nourished patients do not have the reserves to fight off illness, and in many cases, are also immunosuppressed with delayed wound healing. Malnutrition is a major public health problem. Approximately 30% of patients who are admitted t...

Preliminary Communication Caring for the Critically Ill PatientJanuary 17, 2020 Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial Tomoko Fujii, Nora Luethi, Paul J. Young, et al JAMA. Published online January 17, 2020. doi:10.1001/jama.2019.22176 Abstract Importance  It is unclear whether vitamin C,...

Original Investigation |Caring for the Critically Ill Patient | January 17, 2020 Effect of Stress Ulcer Prophylaxis With Proton Pump Inhibitors vs Histamine-2 Receptor Blockers on In-Hospital Mortality Among ICU Patients Receiving Invasive Mechanical Ventilation: The PEPTIC Randomized Clinical Trial The PEPTIC Investigators for the Australian and New Zealand Intensive Care Society Clinical Trials Group, Alberta Health Services Critical Care Strategic Clinical Networ...