Sedation in intensive care unit (ICU) patients is assumed to facilitate proper care with improved patient comfort and safety, though long-term use is fraught with potential serious adverse effects. The use of dexmedetomidine, a sedative with alpha-2 agonist properties, may enhance patient safety and comfort in long-term sedation, but evidence has been limited and inconclusive. […]

For more than 40 years, epinephrine has been regarded as a standard of care in advanced cardiac life support. In the March 21 issue of The Journal of the American Medical Association, Hagihara et al performed the largest prospective, nonrandomized observational study to date to determine how epinephrine use in cardiopulmonary resuscitation before hospital arrival was […]

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Limited observational data have suggested that amantadine, an indirect dopamine agonist and N-methyl-D-aspartate antagonist, may have favorable neurobehavioral effects for patients with severe traumatic brain injury (TBI). The favorable effects may be due to enhanced neurotransmission during a period of dopamine depletion and neuronal hypoexcitability following brain injury. In the March issue of  The New […]

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As our understanding of the coagulation cascade evolves, intensivists have sought ways to manipulate the pathway to attenuate the effects of hemorrhagic shock. Tranexamic acid (TXA) is a lysine analog that binds the plasminogen molecule, inhibiting fibrinolysis. In the February issue of Archives of Surgery, Morrison et al report their experience in the use of […]

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The amount of artificial nutrition required to optimize outcomes in patients with acute lung injury (ALI) is unknown. To address this problem, the Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, headed by Todd Rice, MD, MS, from VanderbiltUniversityinNashville,Tennessee,USA, conducted a prospective, randomized open-label trial comparing the effect of initial trophic enteral feeding vs. initial […]

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