Monitoring Spinal Cord Tissue Oxygen in Patients With Acute, Severe Traumatic Spinal Cord Injuries
OBJECTIVES: To determine the feasibility of monitoring tissue oxygen tension from the injury site (pscto2) in patients with acute, severe traumatic spinal cord injuries. DESIGN: We inserted at the injury site a pressure probe, a microdialysis catheter, and an oxygen electrode to monitor for up to a week intraspinal pressure (ISP), spinal cord perfusion pressure (SCPP), tissue glucose, lactate/pyruvate ratio (LPR), and pscto2. We analyzed 2,213 hours of such data. Follow-up was 6–28 months postinjury. SETTING: Single-center neurosurgical and neurocritical care units. SUBJECTS: Twenty-six patients ...
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

A Minimally Invasive and Highly Effective Extracorporeal CO2 Removal Device Combined With a Continuous Renal Replacement Therapy
CONCLUSIONS: This new extracorporeal ion-exchange resin-based multiple-organ support device proved extremely high efficiency in CO2 removal and continuous renal support in a preclinical setting. Further studies are required before clinical implementation. (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Evaluating Vitamin C in Septic Shock: A Randomized Controlled Trial of Vitamin C Monotherapy*
CONCLUSIONS: Vitamin C monotherapy failed to significantly reduce mortality in septic shock patients as hypothesized. Our findings do not support its routine clinical use for this purpose. (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Early Neuromuscular Blockade in Moderate-to-Severe Pediatric Acute Respiratory Distress Syndrome
OBJECTIVES: The use of neuromuscular blocking agents (NMBAs) in pediatric acute respiratory distress syndrome (PARDS) is common but unsupported by efficacy data. We sought to compare the outcomes between patients with moderate-to-severe PARDS receiving continuous NMBA during the first 48 hours of endotracheal intubation (early NMBA) and those without. DESIGN: Secondary analysis of data from the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) clinical trial, a pediatric multicenter cluster randomized trial of sedation. SETTING: Thirty-one PICUs in the United States. PATIENT...
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Differential Effects of Gamma-Aminobutyric Acidergic Sedatives on Risk of Post-Extubation Delirium in the ICU: A Retrospective Cohort Study From a New England Health Care Network
OBJECTIVES: To evaluate whether different gamma-aminobutyric acidergic (GABAergic) sedatives such as propofol and benzodiazepines carry differential risks of post-extubation delirium in the ICU. DESIGN: Retrospective cohort study. SETTING: Seven ICUs in an academic hospital network, Beth Israel Deaconess Medical Center (Boston, MA). PATIENTS: Ten thousand five hundred and one adult patients mechanically ventilated for over 24 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We tested the hypothesis that benzodiazepine versus propofol-based sedation is associated with fewer d...
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Outcome of Temporary Circulatory Support As a Bridge-to-Left Ventricular Assist Device Strategy in Cardiogenic Shock Patients
CONCLUSIONS: BTL strategy is not associated with a lower survival among cardiogenic shock patients with LVAD implantation. Predictors of mortality are combined surgery with LVAD, higher BMI, and HF duration. (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Simulation Versus Interactive Mobile Learning for Teaching Extracorporeal Membrane Oxygenation to Clinicians: A Randomized Trial
CONCLUSIONS: Simulation was superior to QuizTime and experiential learning with regard to extracorporeal membrane oxygenation knowledge acquisition. Further studies are needed to ascertain the effect of these interventions on knowledge retention, clinical performance, and patient outcomes. (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Phase 2 Vitamin C Sepsis Trials: Another Brick in the (Evidence) Wall?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Editorials Source Type: research

The Puzzles of Ventilator-Associated Pneumonia and COVID-19: Absolute Knowns and Relative Unknowns*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Editorials Source Type: research

Do Tracheostomy and Gastrostomy Confer Immortality in COVID-19?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Editorials Source Type: research

Falling for It: Of Falls, Families, and Delirium*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Editorials Source Type: research

Heterogeneity in Clinical Presentations of Sepsis: Challenges and Implications for “One-Size-Fits-All” Time-to-Antibiotic Measures*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Editorials Source Type: research

Resuscitation in Out-of-Hospital Cardiac Arrest Patients With COVID? Never Tell Me the Odds!*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Editorials Source Type: research

Moving Forward: Frailty and Adverse Sepsis Outcomes*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Editorials Source Type: research

Death and Dying in the ICU*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Editorials Source Type: research