New-onset atrial fibrillation (AF) is a recognized complication of severe sepsis and may be associated with adverse outcomes such as stroke or death. In this month’s issues of the Journal of the American Medical Association, Walkey et al investigated the association of severe sepsis and new-onset AF with the adverse outcomes of in-hospital mortality and […]

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Ventilator-associated pneumonia (VAP) poses a significant patient safety threat for intensive care unit (ICU) patients and has an attributable mortality rate that may exceed 50%.  In the November issue of Lancet Infectious Diseases, Sonia Labeau, MD, and colleagues from Ghent University, Belgium, conducted a systematic review and meta-analysis to determine whether oral care with chlorhexidine […]

Supraphysiological concentrations of sodium and chloride are present in routinely used intravenous fluids.  It is widely understood that the use of 0.9% saline and other chloride-rich solutions in critically ill patients causes metabolic acidosis, decreases the strong ion difference, and may lead to worse outcomes.  In this month’s issue of Critical Care Medicine, Nor’azim Yunos […]

A number of previous studies, including three randomized controlled trials, demonstrated an association with improved outcomes in patients with acute lung injury (ALI) or sepsis-induced respiratory failure when fatty acid supplements were administered. In the October issue of the Journal of the American Medical Association, Todd Rice, MD, MS, and investigators from the National Heart, […]

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Unintended consequences, such as limited ability to think beyond algorithms, may exist when protocols are used extensively. In the September issue of the Journal of American Medical Association, Prasad et al studied the relationship between critical care training under high- and low-intensity institutional mechanical ventilation protocols and subsequent knowledge about ventilator management.

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