Critical care is the moment when time, physiology, and decisions collide—and the margin for error is thin. It’s not defined by an ICU bed; it’s defined by the need for emergent care to prevent or treat life-threatening illness.
REBEL Crit exists to help clinicians deliver the best possible care to the sickest patients. We critically appraise the latest literature, translate findings into bedside practice, and publish review articles on complex topics designed for busy providers.
In patients with intermediate-risk pulmonary embolism (PE), does ultrasound-facilitated, catheter-directed fibrinolysis (US-CDT) plus anticoagulation improve clinical outcomes compared to anticoagulation alone?
In this secondary analysis of the DOSE-VF Trial, one of the first RCTs assessing alternative defibrillation strategies in OHCA, the authors reviewed defibrillation files from the initial study to answer whether reduced time in VF between shocks could explain the ...
What are the differences in efficacy and safety of HFNC, NIPPV, and facemask oxygen for preoxygenation of patients who are critically ill requiring tracheal intubation?
The OPTION trial evaluated IV tenecteplase (0.25 mg/kg) in CT perfusion–selected non-LVO ischemic stroke patients treated 4.5–24 hours after last-known-well. Tenecteplase improved excellent 90-day outcomes (mRS 0–1) but increased symptomatic intracranial hemorrhage, with the benefit–harm balance sensitive to outcome and ...
The EVERDAC trial sought to determine if managing shock with noninvasive brachial cuff monitoring is noninferior to early (<4 hours) arterial catheter placement
The optimal treatment strategy for intermediate-risk (submassive) pulmonary embolism remains controversial. These patients are not in shock, but they have right ventricular (RV) dysfunction and myocardial injury, which are associated with higher risk for clinical decompensation and adverse outcomes.
The cornerstone of acute ischemic stroke (AIS) management involves timely reperfusion of the ischemic brain tissue. Intravenous thrombolysis with alteplase has been the standard of care for AIS within 4.5 hours of symptom onset, based on pivotal trials such as ...
Prior research has shown that deep tracheal suctioning can result in more rapid development of hypoxemia. It is unclear if continuous suctioning during intubation poses a similar risk. Does the application of continuous suctioning during rapid sequence intubation (RSI) result ...
With high flows, modest PEEP, and effective dead-space washout, HFNC can improve oxygenation and decrease work of breathing while preserving the ability to talk, cough, eat, and interact with staff and family. The RENOVATE trial set out to answer a ...
Etomidate or ketamine? The debate over the ideal agent for emergency rapid sequence intubation (RSI) has raged for years with no clear winner. Etomidate has been touted in the past for its rapid onset and minimal intrinsic effects on hemodynamics. ...
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