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Use 6 ml/kg predicted body weight tidal volumes in all patients with ARDS. This is the single most important intervention in ARDS management and is standard of care worldwide. Plateau pressure should be kept ≤30 cmH₂O.

Prone positioning ≥16 hours/day should be used in all patients with severe ARDS (P/F <150) who are on lung-protective ventilation. This is a strong recommendation in current ATS/SCCM guidelines.

Protocolized EGDT (with ScvO₂ monitoring, CVP targets, and blood transfusions) is not superior to usual care in septic shock. The key elements that matter are: early recognition, prompt antibiotics, and adequate resuscitation — not the specific protocol endpoints.

HFOV is HARMFUL in ARDS and should NOT be used. This trial, along with OSCAR (UK), definitively ended routine HFOV use in adult ARDS. Know this for boards — HFOV increases mortality.

ACURASYS showed benefit, but the larger ROSE trial (2019) showed no benefit with lighter sedation as control. Current guidelines do NOT routinely recommend NMBAs in ARDS — use only for specific indications (severe dyssynchrony, refractory hypoxemia).

Routine early NMBAs do NOT improve outcomes in ARDS when compared to light sedation. NMBAs should be reserved for specific indications: severe patient-ventilator dyssynchrony, refractory hypoxemia, or prone positioning facilitation.

A conservative fluid strategy (targeting CVP <4 or PAOP <8) improves lung function and reduces time on ventilator in ARDS without harming kidneys. Avoid fluid overload in ARDS after initial resuscitation.

Protocolized EGDT offers no benefit over usual care in septic shock. Together with ProCESS and ProMISe, ARISE confirmed that the key elements of sepsis care are early recognition, antibiotics, and adequate resuscitation — not specific hemodynamic targets.

Balanced crystalloids (lactated Ringer's or PlasmaLyte) are preferred over normal saline for most ICU patients. Normal saline should be avoided in large volumes due to hyperchloremic acidosis and AKI risk. Exception: head trauma (avoid hypotonic solutions).

Vasopressin 0.03 units/min can be added to norepinephrine as a second-line vasopressor in septic shock to reduce norepinephrine requirements. It is not superior to norepinephrine as monotherapy. Per SSC guidelines, add vasopressin when norepinephrine dose is ≥0.25 mcg/kg/min.

Know the ABCDEF bundle: Assess/treat pain, Both SAT and SBT, Choice of sedation, Delirium assess/manage, Early mobility, Family engagement. Light sedation (RASS −1 to 0) is standard. Benzodiazepines increase delirium — use propofol or dexmedetomidine. CAM-ICU is the validated delirium tool.

Know the Sepsis-3 definition (organ dysfunction + suspected infection), qSOFA criteria, and the Hour-1 bundle. Norepinephrine = first-line vasopressor. Add vasopressin at high norepinephrine doses. Hydrocortisone 200 mg/day for refractory shock. Antibiotics within 1 hour of sepsis recognition.

Tight glycemic control (80–110 mg/dL) is HARMFUL in ICU patients — it increases mortality due to hypoglycemia. Target blood glucose 140–180 mg/dL in critically ill patients. This is the current SSC and ADA recommendation. Avoid hypoglycemia at all costs.

EOLIA did not demonstrate a statistically significant mortality benefit for early ECMO in severe ARDS compared to an optimized conventional ventilation strategy with rescue ECMO. However, the high crossover rate to rescue ECMO in the control arm complicates interpretation.

Hydrocortisone in septic shock does not improve 28-day mortality but may facilitate earlier vasopressor weaning and shock reversal, albeit with increased adverse events.

Daily interruption of continuous intravenous sedation in mechanically ventilated patients significantly reduces the duration of mechanical ventilation and ICU length of stay without increasing adverse events, and should be a standard practice.

Early, aggressive, protocol-driven resuscitation targeting hemodynamic goals in severe sepsis and septic shock can significantly improve patient survival.

This observational study suggested a dramatic reduction in mortality and vasopressor dependence with the HAT protocol in severe sepsis and septic shock, prompting widespread interest and further investigation.

For non-critically ill patients in the ED, balanced crystalloids are superior to normal saline in reducing major adverse kidney events.

Intensive insulin therapy targeting strict glycemic control (80-110 mg/dL) in critically ill surgical patients can reduce mortality and morbidity.

Targeted temperature management at 36°C is non-inferior to 33°C for mortality and neurologic outcome after out-of-hospital cardiac arrest, suggesting that avoiding fever is paramount, but deeper hypothermia may not offer additional benefit.

High-flow nasal cannula should be considered as a first-line oxygen delivery strategy for patients with acute hypoxemic respiratory failure, as it significantly reduces the need for endotracheal intubation compared to standard oxygen therapy and may improve patient outcomes.

Prophylactic use of non-invasive ventilation (BiPAP) immediately after extubation can significantly reduce reintubation rates and post-extubation respiratory failure in high-risk critical care patients. This strategy should be considered for patients with underlying hypercapnic respiratory failure or complex weaning histories.