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Rebel Category: REBEL Crit

The LOCO2 Trial: Liberal or Conservative Oxygen Therapy for Acute Respiratory Distress Syndrome

Background: In patients with acute respiratory distress syndrome (ARDS) the National Heart, Lung, and Blood Institute ARDS clinical trials network recommends a target partial pressure of arterial oxygen (Pao2) between 55 and 80 mmHg. Goals of arterial oxygenation are not based ...

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Thoracic and Respiratory

Fluid Administration in End-Stage Renal Disease for Severe Sepsis and Septic Shock by Shyam Murali, MD

Background: In end-stage renal disease (ESRD) patients on hemodialysis (HD), infection is the second most common cause of mortality after cardiovascular disease (Sarnik 2000). Because of the systemic inflammation and increased capillary permeability, septic patients are at significant risk for fluid ...

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Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseResuscitation

Peripheral Pressors: 6 Pearls to Not F*#k Up the Arm

Traditionally, vasopressor infusions have been done through central venous catheters (CVCs) due to the hypothetical risk of extravasation injury to extremities when given through peripheral IVs.  The documented risk of extravasation from peripheral pressors is 3 – 6% . Hypothetically, ...

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Procedures and Skills

New Opioid Use After Invasive Mechanical Ventilation and Hospital Discharge

Background Information: Physicians have and continue to heavily contribute to the current opioid epidemic in the United States and Canada.1 Although much of the focus has been opioid prescriptions given to patients in the emergency department,2,3 not much attention has ...

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Psychiatry/Behavioral HealthToxicology

The HYVCTTSSS Trial: The “Metabolic Cocktail” in Another RCT

Background: Getting the basics right in all illness is vital. In sepsis, this means appropriate use of antibiotics, judicious fluid resuscitation, and early identification.  Vasopressor support is also essential in the sickest sepsis patients (i.e. septic shock). Should the metabolic ...

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Infectious Disease
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