Pharmacological Insights in Critical Care

Pharmacological Insights in Critical Care

Corticosteroids and hospital-acquired pneumonia

1. Why This Article Matters — Why You Should Read This Corticosteroids are everywhere in critical care. ARDS. Septic shock. COVID-19. Refractory hypoxemia. But when it comes to hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), their role remains controversial, inconsistently applied, and poorly understood. This narrative review tackles a clinically uncomfortable reality: While steroids may […]

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Pharmacological Insights in Critical Care

Vasopressin use across shock states: international insights from an international ESICM-endorsed survey: the PRESS Survey

Summary This international survey, endorsed by the European Society of Intensive Care Medicine (ESICM), assessed the current clinical use of vasopressin and terlipressin in patients with septic shock. The survey included 1,919 intensivists from 124 countries, highlighting significant variability in vasopressin availability, clinical indications, dosing strategies, and discontinuation practices. Results underscore the heterogeneity of current

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Vasopressin use across shock states: international insights from an international ESICM-endorsed survey: the PRESS Survey Read Post »

Pharmacological Insights in Critical Care

Role of liposomal amphotericin B in intensive care unit: an expert opinion paper

Summary of Role of Liposomal Amphotericin B in Intensive Care Unit: An Expert Opinion Paper (Bussini et al.) Abstract Summary: Bussini et al. provide an expert opinion on the appropriate clinical use of Liposomal Amphotericin B (L-AmB) in treating invasive fungal infections (IFI) within the intensive care unit (ICU). The authors detail the limitations of

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Pharmacological Insights in Critical Care

Haloperidol in treating delirium, reducing mortality, and preventing delirium occurrence: Bayesian and frequentist meta-analyses

Summary of Haloperidol in Treating Delirium, Reducing Mortality, and Preventing Delirium Occurrence: Bayesian and Frequentist Meta-Analyses Abstract This study evaluates the efficacy and safety of haloperidol for delirium treatment and prevention in ICU patients using Bayesian and frequentist meta-analyses. Seven RCTs (n = 1,767) assessed delirium treatment, while five RCTs (n = 2,509) examined delirium

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Haloperidol in treating delirium, reducing mortality, and preventing delirium occurrence: Bayesian and frequentist meta-analyses Read Post »

Pharmacological Insights in Critical Care

Inhaled Sedation in Acute Respiratory Distress Syndrome. The SESAR Randomized Clinical Trial

Summary of “Inhaled Sedation in Acute Respiratory Distress Syndrome: The SESAR Randomized Clinical Trial” Abstract This randomized clinical trial compared the efficacy and safety of inhaled sevoflurane versus intravenous propofol for sedation in patients with moderate to severe acute respiratory distress syndrome (ARDS). Conducted across 37 French ICUs, the study enrolled 687 patients to determine

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Inhaled Sedation in Acute Respiratory Distress Syndrome. The SESAR Randomized Clinical Trial Read Post »

Pharmacological Insights in Critical Care

Are contemporary antifungal doses sufficient for critically ill patients? Outcomes from an international, multicenter pharmacokinetics study for Screening Antifungal Exposure in Intensive Care Units—the SAFE-ICU study

Abstract Purpose Appropriate antifungal therapy is a major determinant of survival in critically ill patients with invasive fungal disease. We sought to describe whether contemporary dosing of antifungals achieves therapeutic exposures in critically ill patients. Methods In a prospective, open-label, multicenter pharmacokinetic study, intensive care unit (ICU) patients prescribed azoles, echinocandins, or polyene antifungals for

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Are contemporary antifungal doses sufficient for critically ill patients? Outcomes from an international, multicenter pharmacokinetics study for Screening Antifungal Exposure in Intensive Care Units—the SAFE-ICU study Read Post »

Pharmacological Insights in Critical Care

Pharmacogenetics and the Blood–Brain Barrier: A Whirlwind Tour of Potential Clinical Utility

Abstract Genetic factors influence medication response (pharmacogenetics), affecting the pharmacodynamics and pharmacokinetics of many medicaments used in clinical care. The ability of medications to cross the blood–brain barrier (BBB) represents a critical putative factor in the effectiveness and tolerability of various medications relevant to central nervous system disorders (CNS), cancer, and broader medical conditions at

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Pharmacological Insights in Critical Care

Activity of Antiseptics Against Pseudomonas aeruginosa and Its Adaptation Potential

Abstract Background/Objectives: Pseudomonas aeruginosa rapidly acquires antibiotic resistance and demonstrates increasing tolerance to antiseptics. This study evaluated the activity of eight antiseptics against P. aeruginosa, assessed its ability to develop adaptation to these antiseptics, and, for the first time, determined the Karpinski Adaptation Index (KAI) for this bacterium. Methods: The minimal inhibitory concentration (MIC), susceptibility to antibiotics, bactericidal

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Activity of Antiseptics Against Pseudomonas aeruginosa and Its Adaptation Potential Read Post »

Pharmacological Insights in Critical Care, Sepsis

Ivabradine in Septic Shock: A Narrative Review

Abstract In patients with septic shock, compensatory tachycardia initially serves to maintain adequate cardiac output and tissue oxygenation but may persist despite appropriate fluid and vasopressor resuscitation. This sustained elevation in heart rate and altered heart rate variability, indicative of autonomic dysfunction, is a well-established independent predictor of adverse outcomes in critical illness. Elevated heart

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Pharmacological Insights in Critical Care

Urgent Reversal of Direct Oral Anticoagulants in Critical and Life-Threatening Bleeding: A Multidisciplinary Expert Consensus

Abstract Direct oral anticoagulants (DOACs) are increasingly being used due to their improved efficacy/safety ratio and lower clinical and economic burden when compared to vitamin K antagonists. However, bleeding is still the most frequent complication associated with DOACs, and although rare, bleeding episodes can be life-threatening or critical. The impact of DOAC anticoagulation activity during

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Urgent Reversal of Direct Oral Anticoagulants in Critical and Life-Threatening Bleeding: A Multidisciplinary Expert Consensus Read Post »

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