Intracranial pressure (ICP) monitoring is regarded as standard care for patients with severe traumatic brain injury (TBI). Nevertheless, even in high-income countries, the efficacy of ICP monitoring has been questioned. The identification of a group of intensivists in Bolivia and Ecuador who routinely manage TBI patients without ICP presented an opportunity for Randall Chestnut and [...]

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Severe sepsis and septic shock remain major public health threats worldwide. Broad global variations in mortality have been reported, ranging from 22% to more than 75%. In the December issue of Lancet Infectious Diseases, Society of Critical Care Medicine past-president Mitchell M. Levy and investigators from the Surviving Sepsis Campaign compared models of care and [...]

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Despite the increase in evidence-based guidelines for advanced cardiac life support and resuscitation care during the past decade, it is not clear whether survival and neurologic function after in-hospital cardiac arrest have improved. In the November issue of The New England Journal of Medicine, investigators with the American Heart Association’s Get with the Guidelines® (GWTG)-Resuscitation [...]

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The use of low tidal volumes is a standard of care supported by a wide body of evidence that has demonstrated the efficacy of this intervention for saving the lives of patients with acute respiratory distress syndrome (ARDS) and mild ARDS (formerly acute lung injury). The ideal ventilator strategy for intensive care unit patients without [...]

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Strategies to reduce excessive sedation, including protocol implementation, have been shown to reduce length of stay and improve morbidity and mortality rates for critically ill patients. While intuitively appealing, the results of some clinical trials in this area have been inconsistent. In the October issue of The Journal of the American Medical Association, investigators from [...]

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