EMCrit Project

The basics often aren’t exciting, but it’s important to get them right.  DVT prophylaxis is a good example of this.  Most critically ill patients will receive DVT prophylaxis at some point during their ICU stay (that’s 5 million patients per year in the United States alone).  Thus, even minor tweaks in the optimal treatment for […]

The preliminary report of the Adaptive COVID-19 Treatment Trial (ACTT-1), a multi-center, placebo-controlled RCT on remdesivir is here!​1​  The one we’ve all been waiting for!  Patients Patients were recruited from 60 sites in several countries.  Inclusion criteria were patients who were hospitalized due to COVID-19 with evidence of lower respiratory tract infection, defined in terms […]

Sodium Zirconium Cyclosilicate (SZC) is a potassium-exchange resin similar in concept to sodium polystyrene sulfonate (Kayexalate).  It’s not particularly new, as the original studies were performed around 2015.  Accumulating evidence over the last five years supports the drug’s safety.  The real question is how effective it may be.  Efficacy data for short-term improvement in potassium […]

COPD exacerbation is bread and butter critical care.  However, familiarity can breed concept.  Thus, it’s important to always approach patients labeled with “COPD exacerbation” with fresh eyes, because they can present with other pulmonary pathologies as well.  The primary challenge among these patients is usually utilizing noninvasive support devices to avoid intubation, whenever possible. The […]

One of the most notable controversies in COVID is when steroid might be beneficial.  Since steroid is widely available and inexpensive, this issue has escaped the attention of pharmaceutical companies.  Consequently, evidence surrounding this is extremely sparse.  Available evidence consists largely of retrospective studies which relate steroid administration to outcome.  Such studies are inherently flawed, […]