Tiffany M. Osborn

Is BNP a Marker for Sepsis-Induced Myocardial Dysfunction?

Whether B-type natriuretic peptide (BNP) is an indicator of myocardial dysfunction in patients with septic shock is not certain. In a prospective

Vicks: To Rub or Not to Rub

Vicks VapoRub is not recommended for children younger than 2 years. An 18-month-old girl with symptoms of upper respiratory infection (URI) who presented to the emergency department with worsening dyspnea that developed 30 to 45 minutes after Vicks VapoRub was applied under her nose prompted these authors …

Microcirculatory Changes During Early Goal-Directed Therapy in Septic Shock

Septic shock can induce severe microcirculatory alterations that manifest as reduced end-organ perfusion, reduced oxygen delivery, and increased accumulation of oxygen debt. In a prospective observational study, researchers evaluated whether improvements in early microcirculatory flow during resuscitation are associated with a reduced incidence of end-organ failure in septic patients. Thirty-three adult patients who qualified …

Preoxygenation for Emergency Intubation: Longer Is Not Better

In critically ill patients, 3 to 5 minutes of preoxygenation with 100% oxygen through a resuscitator bag and mask is often recommended for patients who

Limited TTE: Are Patients at the Heart of the Discussion?

Hemodynamic instability in critically ill patients requires rapid evaluation and management. Early cardiac assessment provides essential information for treatment. Prior studies have shown that limited transthoracic echocardiography (TTE), focused on left ventricular function and significant pericardial effusions, is fast and helpful during resuscitation. These authors …

Quality of Life After Treatment for Severe Sepsis: Is the Juice Worth the Squeeze?

A quality-adjusted life-year (QALY) is a measure of the years of life gained through a treatment in a specific population, adjusted for the quality of

Early Goal-Directed Therapy for Sepsis: Show Me the Data!

The validity of various aspects of early goal-directed therapy (EGDT) for patients with severe sepsis and septic shock has been challenged in

Nesiritide and Renal Dysfunction — Another Drop in the Bucket?

Nesiritide, a systemic and pulmonary vasodilator, has been used widely to treat acute decompensated heart failure. In 2005, a meta-analysis demonstrated worsened renal function with nesiritide treatment, which led to an extensive decline in clinical use. In a prospective, randomized, double-blind, placebo-controlled industry-funded trial, researchers evaluated the effect of nesiritide on renal function in patients with moderate renal dysfunction …

Do BNP Levels Predict Outcomes from COPD Flares? Don’t Hold Your Breath

Increased secretion of B-type natriuretic peptide (BNP) might be associated with pulmonary hypertension, sympathetic stimulation, and hypoxia. These

Mortality in ED Sepsis Score — A Solid Step Forward

Early recognition and treatment of severe sepsis and septic shock, the leading causes of death in critically ill noncardiac patients, is essential. The