Posted inCritical Care Neurology news

Rising Hospital Mortality and Escalating Rates of Life-Sustaining Therapy Withdrawal in Critically Ill TBI Patients: A 15-Year Analysis

A 15-year observational study of over 45,000 TBI patients reveals a significant increase in hospital mortality and a tripling of life-sustaining therapy withdrawal, alongside rising rates of hypoxaemia, raising urgent questions about ethical frameworks and neurocritical care management.
Ketamine vs. Etomidate: Does Your Choice of Induction Agent Influence Mortality in the Critically Ill?
Posted inAnesthesiology Critical Care news

Ketamine vs. Etomidate: Does Your Choice of Induction Agent Influence Mortality in the Critically Ill?

This article explores recent evidence comparing ketamine and etomidate for rapid sequence intubation. While new cohort data suggests a mortality benefit for ketamine, meta-analyses of randomized trials show clinical equipoise, highlighting the complex trade-offs between adrenal suppression and hemodynamic stability.
Epinephrine Timing and Dosing in Pediatric In‑Hospital Cardiac Arrest: Mixed Signals — improved ROSC but unclear survival benefit
Posted inCritical Care news Pediatrics

Epinephrine Timing and Dosing in Pediatric In‑Hospital Cardiac Arrest: Mixed Signals — improved ROSC but unclear survival benefit

Recent multicenter studies show earlier and more frequent epinephrine in pediatric in‑hospital cardiac arrest increases ROSC and shortens CPR, but does not consistently improve survival to discharge or favorable neurologic outcome. Evidence supports rapid epinephrine for hemodynamics and ROSC; survival effects remain uncertain.
Pediatric In‑Hospital Cardiac Arrest: Why Adult Resuscitation Lessons Don’t Fully Translate — Airway, Epinephrine, and the Limits of Training
Posted inCritical Care news Pediatrics

Pediatric In‑Hospital Cardiac Arrest: Why Adult Resuscitation Lessons Don’t Fully Translate — Airway, Epinephrine, and the Limits of Training

Recent multicenter studies show declining intra‑arrest intubation, no clear harm from intubation after time‑dependent matching, unclear benefit of epinephrine before defibrillation, and no survival gain from intensive point‑of‑care CPR training—highlighting pediatric physiology and knowledge gaps.
Prehospital Postintubation Hypotension Strongly Linked to 30‑Day Mortality After Severe Traumatic Brain Injury — Especially in Isolated TBI
Posted inCritical Care Emergency Medicine Neurology news

Prehospital Postintubation Hypotension Strongly Linked to 30‑Day Mortality After Severe Traumatic Brain Injury — Especially in Isolated TBI

A multicenter cohort study of 555 patients with severe TBI who underwent prehospital rapid sequence induction found postintubation hypotension (SBP <90 mmHg within 10 minutes) in 19.1%, which was associated with higher 30‑day mortality (AOR 1.70). The association was markedly stronger in isolated TBI (AOR 13.55).
Early Neuromuscular Electrical Stimulation Plus Mobilization Improves 6‑Month Function and Quality of Life After Critical Illness
Posted inCritical Care news Rehabilitation Medicine

Early Neuromuscular Electrical Stimulation Plus Mobilization Improves 6‑Month Function and Quality of Life After Critical Illness

In a randomized, blinded trial of 74 mechanically ventilated ICU patients, adding early NMES to an early mobilization program started within 48 hours improved functional status, independence, mobility, and quality of life up to 6 months after discharge versus mobilization alone.
ICU Structure and Care Processes Drive VAP and CLABSI Burden in Brazilian ICUs: Insights from the IMPACTO‑MR Nested Cohort
Posted inCritical Care Infectious Diseases news

ICU Structure and Care Processes Drive VAP and CLABSI Burden in Brazilian ICUs: Insights from the IMPACTO‑MR Nested Cohort

A large multicenter Brazilian cohort found that ICU-level structure and process measures — staffing, prevention protocols, hand hygiene training, visitation policies, and specific clinical roles — explain substantial between-hospital variability and are associated with lower VAP and CLABSI rates.
Effectiveness of Automated Closed-Loop Ventilation versus Protocolized Conventional Ventilation in Critically Ill Adults: A Comprehensive Evidence Review
Posted inClinical Updates Critical Care news Respiratory

Effectiveness of Automated Closed-Loop Ventilation versus Protocolized Conventional Ventilation in Critically Ill Adults: A Comprehensive Evidence Review

Automated closed-loop ventilation improves ventilation quality but does not increase ventilator-free days at day 28 compared to protocolized conventional ventilation in critically ill adults, with benefits in safety profiles and caregiver workload.
ICU Structure and Care Processes Explain Much of VAP and CLABSI Variation in Brazilian ICUs: Findings from a 50‑Unit IMPACTO‑MR Nested Cohort
Posted inCritical Care Infectious Diseases news

ICU Structure and Care Processes Explain Much of VAP and CLABSI Variation in Brazilian ICUs: Findings from a 50‑Unit IMPACTO‑MR Nested Cohort

A 50‑ICU nested cohort from the IMPACTO‑MR platform links ICU-level structure and care processes to substantially different ventilator‑associated pneumonia and central line‑associated bloodstream infection rates, highlighting modifiable institutional targets in LMIC intensive care.
Digital twins suggest APRV can lower mechanical power and tidal recruitment versus PCV in ARDS — modeling evidence and clinical implications
Posted inCritical Care news Respiratory

Digital twins suggest APRV can lower mechanical power and tidal recruitment versus PCV in ARDS — modeling evidence and clinical implications

High-fidelity digital twins of 98 ARDS patients indicate APRV (Phigh 25/Plow 0, long Tinsp, short Tlow to 75% peak expiratory flow) reduced mechanical power by ~32% and tidal recruitment by ~34% versus recorded PCV, at the cost of controlled hypercapnia; clinical trials are needed.