Combination empirical antimicrobial therapy, including agents that target Gram-negative bacteria, have been reported to lower mortality and morbidity in patients with severe sepsis. Investigators from the German-based SepNet trials group performed a randomized, open-label, parallel-group study to compare the effect of combination therapy with meropenem and moxifloxacin (combination therapy) versus meropenem alone (monotherapy) for empirical […]

Since the 1994 American-European Consensus Conference (AECC), the definition for acute respiratory distress syndrome (ARDS) has been widely used in both clinical practice and applied research. As all critical care practitioners are aware, however, the AECC definition has several problems.  For example, the term acute is ambiguous, the oxygenation criteria can be confounded by positive […]

Several studies have demonstrated improved outcomes when intensive care units (ICUs) are staffed by intensivists. Data supporting the benefits of 24-hour intensivist staffing have been inconsistent, with most studies hailing from single centers. In the May issue of The New England Journal of Medicine, researchers from the University of Pittsburgh School of Medicine in Pennsylvania […]

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Extracorporeal membrane oxygenation (ECMO) for support of adult patients with acute lung failure has been a vigorously debated topic among critical care professionals. As researchers continue to investigate its risks and benefits, indications for use are slowly expanding. Increasing wait times for lung transplants and the poor outcomes associated with endotracheal intubation warrant new support […]

Results of the PROWESS-SHOCK trial, as well as a 2012 Cochrane review, seem to have resolved the controversy related to efficacy of recombinant human activated protein C (rhAPC). However, discussion continues, as the May issue of Critical Care Medicine examines observational data from the Surviving Sepsis Campaign to analyze the association between treatment with rhAPC […]

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