We believe that critical care is not simply a location or a unit in a hospital, but the practice of providing care to those who need urgent support to treat or prevent a life-threatening illness. Whether you’re a paramedic, nurse, EM, IM, CCM doc, etc…

 

REBEL Crit

 

will help you critically appraise the literature so that you can deliver the highest quality, evidence based and compassionate care to your patients. REBELCrit not only review’s recent publications, but has many review article’s, on often complex topics, to help you, the busy provider, continue to provide the best care possible. Soon, REBELCrit will be launching a critical care podcast through our already popular REBELCast! REBELCrit strives to give you the most up to date and timely information so that you can be the best provider you can be and deliver the best care to your critically ill patients!

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  • REBEL Crit
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  • REBEL Crit

The VICTAS Trial: How Many More RCTs do we Need on the Metabolic Cocktail in Sepsis?

Background: Since the publication of the before and after Marik trial [1] published in 2016, there have been six randomized clinical trials trying to answer the question of the utility of the metabolic cocktail (Vitamin C, thiamine, and hydrocortisone) in …

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Infectious Disease

The HOT-ICU Trial: Lower vs Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure

Background: Though oxygen is fundamental for life, supra-physiological levels can be deleterious. Several randomized controlled trials and meta-analyses have been conducted in the critically ill to determine whether a conservative oxygenation approach compared to a liberal oxygenation approach is beneficial. …

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Thoracic and Respiratory

The ARREST Trial: ECMO or EC-No for Refractory Cardiac Arrest?

Background:  Despite medical advances, survival after out of hospital cardiac arrest (OHCA) is still largely dependent on high-quality CPR. Many of these events are due to a primary cardiac event, likely coronary artery occlusion. Current guidelines recommend reperfusion therapy following …

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Resuscitation

The RELAx Trial: What is the Optimal PEEP in Patients Without ARDS?

Background: It has well been established that low tidal volume ventilation minimizes potentially iatrogenic harms of mechanical ventilation.  What is less clear is the use of higher positive end expiratory pressure (PEEP) in patients without acute respiratory distress syndrome (ARDS). …

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Thoracic and Respiratory

MIRACLE2 Risk Score for Early Prediction of Neurologic Outcome in Out-of-Hospital Cardiac Arrest

Background Information: Out-of-hospital cardiac arrest (OHCA) remains a diagnostic challenge to providers and a significant burden on healthcare systems globally. Despite the advancement of invasive medical therapies such as percutaneous coronary intervention (PCI) and extracorporeal membranous oxygenation (ECMO) at designated cardiac …

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CardiovascularNeurologyResuscitation

Respiratory Failure and Airway Management in the Pregnant Patient

Introduction: Respiratory failure is an uncommon but important complication in pregnancy and the postpartum period, occurring 1 in 500 pregnancies.1 Respiratory failure can result from pregnancy-related conditions, conditions exacerbated by pregnancy, or pathologies common to the general population (Table 1). …

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Obstetrics and GynecologyResuscitation

Are Peripheral Vasopressors Causing Too Many Complications?

Background:  Vasopressors are usually given through central venous catheters (CVC). This, however, is a time-consuming process and placement of a peripheral venous catheter (PIV) is much faster. Each hour of delay has been associated with a 2% increase in in-hospital mortality.2 Using …

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Resuscitation

The 1st Community ECMO Program in the US

Background: In the US out-of-hospital cardiac arrest (OHCA) has an estimated survival rate of <10% overall, but slightly better survival rates with shockable rhythms of approximately 30% [2]. A small proportion of these patients will have refractory VF/VT OHCA not …

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Resuscitation

REBEL Cast Ep91: Static Ultrasound vs Landmark Placement of Subclavian Central Lines

Background Information: Central venous catheterization is a common procedure performed in the ICU for the purposes of drug administration and resuscitation. The subclavian vein is the more preferred access site given its fixed puncture location, ease for nursing access and low …

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Procedures and SkillsResuscitation

Effectiveness of Sodium Bicarbonate Administration on Mortality in Cardiac Arrest Patients: A Systematic Review and Meta-Analysis

Background/Introduction: The use of Sodium Bicarbonate (SB) in cardiac arrest has had a complicated history with strong and varied opinions on its effectiveness. SB was recommended in earlier ACLS guidelines, mostly stemming from the notion that severe metabolic acidosis due to …

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Resuscitation

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