Critical Care Alert
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Effect of Stress Ulcer Prophylaxis Choice on Mortality in Mechanically Ventilated Adults
Proton pump inhibitors reduce the risk of clinically important bleeding, but they may have no effect on the risk of 90-day mortality compared to histamine-2 receptor antagonists.
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Palliative Care and Ethical Considerations in the COVID-19 ICU
The COVID-19 pandemic has created an ICU environment different from what we have ever seen in our lifetimes that has deep palliative care and ethical repercussions.
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COVID-19 and Steroids: Is There a Consensus on the Controversy?
A retrospective, single-center cohort study among 201 adults admitted with COVID-19 pneumonia revealed that risk factors associated with the development of acute respiratory distress syndrome (ARDS) and progression from ARDS to death included older age, neutrophilia, organ dysfunction, and coagulation derangement. Treatment with methylprednisolone may be beneficial for these patients.
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First-Pass Success Rate Between Rocuronium and Succinylcholine in Emergent Out-of-Hospital Endotracheal Intubation
This randomized, single-blind, noninferiority trial compared rocuronium and succinylcholine for rapid sequence intubation. Rocuronium was noninferior to succinylcholine with respect to the primary endpoint of first-pass intubation success.
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Improving Sepsis Outcomes: Raising the Bar
In addition to compliance with the sepsis bundles, how can critical care providers revolutionize and individualize sepsis care for optimal results?
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Preventing Post-Extubation Respiratory Failure: Can We Decrease Risk in our High-Risk Populations?
A multicenter, randomized clinical trial of 641 adults deemed ready for weaning after at least 24 hours of mechanical ventilation revealed that the use of high-flow nasal oxygen (HFNO) with noninvasive ventilation immediately after extubation significantly decreased the risk of reintubation compared to HFNO alone in mechanically ventilated patients who were at high risk of extubation failure.
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High-Flow Nasal Cannula Oxygen Therapy in Adult Acute Care
A relatively new modality, high-flow nasal cannula oxygen therapy is used commonly to treat acute respiratory failure.
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Early Data on Remdesivir for Severe COVID-19: A Promising Start?
In this group of patients hospitalized with severe COVID-19, the majority of whom required invasive ventilation, 68% showed clinical improvement after treatment with remdesivir on a compassionate-use basis.
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Anticoagulation Therapy in Patients with Severe COVID-19
In a retrospective study involving 449 patients with severe COVID-19 requiring intensive care unit admission, those patients with a positive sepsis coagulation score or D-dimer greater than 3.0 mcg/mL who received prophylactic doses of low molecular weight heparin exhibited lower 28-day mortality.