Is Prophylaxis for Stress Ulceration Useful?
First described in the 1970s, stress-related mucosal damage (SMRD) was once considered a common complication of critical illness. However, it is now questionable whether the early descriptive work on the…
CRITICAL CARE
Should Fever Be Treated?
Body temperature is a fundamental physiologic parameter that is altered by several pathologic processes. Abnormal or altered body temperature is a key to aid in diagnosis and is often a…
What Fluids Should I Give to the Critically Ill Patient? What Fluids Should I Avoid?
Many critically ill patients are hypovolemic, which may result in impaired cardiac output and organ perfusion, leading to poor outcome. Therefore fluid therapy is a mainstay in the resuscitation of…
What Are the Best Tools to Optimize the Circulation?
Implicit in any attempt to optimize the circulation are two key issues. First, it is important to identify those measures or parameters that constitute the most appropriate treatment options. Second,…
What Strategies Can Be Used to Optimize Antibiotic Use in the Critically Ill?
Septic patients in the intensive care unit (ICU) represent some of the sickest patients in the hospital, and optimal initial antibiotic selection is paramount to their survival. In this patient…
How Do I Manage Hemodynamic Decompensation in a Critically Ill Patient?
The ability to evaluate and manage a critically ill patient is one of the most important skills any intensivist brings to the bedside. Patients already resident in the intensive care…
Does the Use of Echocardiography Aid in the Management of the Critically Ill?
Rapidly identifying causes of hemodynamic instability is essential during the care of critically ill patients. Central venous pressure catheters, pulse pressure variability devices, and transesophageal echocardiograms are commonly used in…
How Does One Evaluate and Monitor Respiratory Function in the Intensive Care Unit?
Over recent decades, we have seen many advancements in mechanical ventilation (MV) and respiratory monitoring, some resulting in documented decreases in mortality. Nevertheless, the mortality attributable to acute respiratory distress…
What Factors Predispose Patients to Acute Respiratory Distress Syndrome?
Acute respiratory distress syndrome (ARDS) is a common complication of critical illness or injury associated with significant morbidity and mortality. The pathogenesis of ARDS involves mechanical and inflammatory injury to…
Is Extracorporeal Life Support an Evidence-Based Intervention for Critically Ill Adults with ARDS?
Extracorporeal life support (ECLS) is a treatment option for patients with inadequate oxygen delivery. Inadequate oxygen delivery can result from either ineffective oxygenation from severe lung disease or ineffective cardiac…
