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Intensive Care

January 8, 2015
Read this amusing article that documents a series of names of genuine doctors on the  UK  GMC registar such as psychiatrists called Dr Bhatti, Dr Moodie, a Genitourinary doctor called Dr Hussey and general surgeons called Mr Gore and Mr butcher !  Got any of your own ? Post them now in the comments section     
December 3, 2014
This single institution study evaluated the effects of 24-hr in hospital congenital cardiac surgery coverage on outcomes for perioperative congenital heart surgery ECMO.  Institution of 24-hr coverage reduced hospital mortality from 68% to 43% as well as rates of cardiac arrhythmias and pneumonia.  24-hr coverage was independently associated with a r
December 1, 2014
This is an excellent article on the feasibility of offering Veno Arterial ECMO in outlying community hospitals for Refractory Cardiogenic Shock (RCS).  The Authors review a four year time period and describe assessing 104 patients of whom 87 were deemed eligible for V-A ECMO therapy.
November 25, 2014
In a retrospective review of 45 cases where patients were placed on VV ECMO, investigators from Seoul performed a multivariate analysis of pre-ECMO risk factors  that might be predictive of  an unsuccessful ECMO wean.  Notably, successful weaning from ECMO was only 46%, and overall survival was only 18%.
November 10, 2014
The authors explored a sample of Medicare patients who survived sepsis during hospitalization to assess the impact of afib developing during sepsis on long-term outcomes.  Of nearly 139,000 sepsis survivors, 7% had new onset afib during sepsis.  Of those pts, 55% were found to have afib after hospitlization.  New onset afib during sepsis was associat
October 9, 2014
A well done video describing radial artery line placement aided by US.
October 9, 2014
This randomized trial investigated two different thresholds for triggering transfusion in patients with septic shock: 9 g/dL or 7 g/dL.  The lower threshold group received a median of 1 unit of blood compared to 4 in the higher threshold group.  90 day mortality rates and other morbidity were similar between the groups.  
September 29, 2014
This randomized double-blind multicenter study involving 667 pts evaluated the utility of IV fenoldopam in reducing the rate of renal replacement therapy for patients undergoing cardiac surgery who exhibit postoperative acute kidney injury.  Fenoldopam did not importantly reduce the need for renal replacement therapy or 30 day mortality.  Its use was
August 25, 2014
This interesting overview points out the negative effects of adrenaline on outcomes in a number of observational and randomized studies of patients experiencing cardiac arrest.  The author recommends using Vasopressin after the first dose of adrenaline during resuscitation from cardiac arrest.