Category: Featured Articles

‘Tis the (Flu) Season – Influenza Infection in Critically Ill Patients
by C. Patrick Henson, DO

As influenza season begins in the United States, we should reflect on the nature of the virus, pathological presentation and treatment considerations. Multiple types of influenza exist, with type A accounting for the most severe manifestations in humans and responsible for the major pandemic outbreaks, notably in 1918, 1957, 1968, and 2009. Types B and C also infect humans but result in a more typical seasonal infection.

Continue Reading…
Critical Care Pain Management in the Era of Enhanced Recovery and the War on Opioids
by Christina Boncyk, MD and C. Patrick Henson, DO

Chronic pain syndromes are a persistent problem in the United States, with conservative estimates suggesting a cost $560 to $635 billion dollars annually. Chronic pain following intensive care unit (ICU) survival is difficult to quantify, as patient populations vary across hospital centers and within different ICU settings; however, current evidence demonstrates that anywhere from 12-60% of patients remain affected by chronic pain at 6-months to a year following ICU admission, which contributes to a significant portion of diagnoses nationally.

Continue Reading…
The Role of Intensivists in the Management of Chimeric Antigen Receptor T Cell Related Toxicities
by German Echeverry, M.D.

Chimeric Antigen Receptor (CAR) T cell therapy is a promising novel cancer treatment modality recently approved by the Food and Drug Administration for relapsed/refractory B cell liquid tumors. Though its use is currently limited to a few designated centers across the US, if this line of therapy continues to deliver on the hype and new indications continue to arise as expected, it is likely that in the coming years it will be coming to a hospital (and an ICU) near you.

Continue Reading…
Pro and Con: Vitamin C and Sepsis – Pro
by Nicholas C. Zimick, MD, MS

“Part of this complete breakfast.” This is the closing line of nearly every breakfast food commercial since at least the mid-1980s. The final scene universally depicts two mainstays: the product, and a cup of orange juice. In popular culture, citrus fruits are crucial to balanced nutrition and provide essential vitamin C. Colloquially, this nutrient is well known to stave off scurvy; but, medically, it has far more powerful potential as a tool to combat the sequelae of infection.

Continue Reading…
Pro and Con: Vitamin C and Sepsis – Con
by Rhea Ittoop, MD MPH

Is Vitamin C (ascorbic acid) the new and improved answer to decreasing sepsis-related mortality? It’s unclear. Up until this point, ascorbic acid has been studied in small cohorts of mostly cancer or burn patients. Studies in these populations have had variable results, some showing no difference in outcomes and others displaying impressive benefits.

Continue Reading…