There is considerable interest in understanding genetic determinants of critical illness to improve current risk stratification models, provide individualized therapies, and improve our current understanding of disease mechanisms. This review provides a broad overview of genetic nomenclature, different study designs, and problems unique to each of these study designs in critical illnesses. Well...

Some physicians caring for critically ill patients have preferences for withdrawing some forms of life support over others, even after the decision to withdraw life support has already been made. Past research has attempted to explain these preferences by variations in clinical circumstances. The authors wondered whether differences in the forms of life support themselves might be important, an...

BACKGROUND Diagnostic error and delay are critical impediments to the safety of critically ill patients. Checklist for early recognition and treatment of acute illness and injury (CERTAIN) has been developed as a tool that facilitates timely and error-free evaluation of critically ill patients. While the focused history is an essential part of the CERTAIN framework, it is not clear how best to ...

Acute renal failure (ARF) is broadly defined as deterioration of renal function over days to weeks, a common occurrence in intensive care unit (ICU) patients; incidence and mortality estimates vary according to ARF definition and associated morbidities.'-"he mortality of ARF is 50-80% in ICU populations, and has not declined significantly since the initial marked benefit of acute dialysis thera...

Methods We performed a two center observational study of patients treated in medical and surgical intensive care units in Boston, Massachusetts. All data was obtained from the Research Patient Data Registry at Partners HealthCare. We studied 81,061 patients, age ≥ 18 years, who received critical care between 1997 and 2012 and who survived 72 hours following ICU admission. We excluded patients w...

Critically ill patients, almost by definition, are catabolic and often hypermetabolic. Although it is generally accepted that such patients would benefit from nutritional support, there are remarkably little data to support this premise. Several experts believe that prospective, randomized, controlled studies to document the efficacy of nutrition support in improving outcome in critically ill p...

An exaggerated, dysregulated host response to insults such as infection (i.e. sepsis), trauma and ischaemia-reperfusion injury can result in multiple organ dysfunction and death. While the focus of research in this area has largely centred on inflammation and immunity, a crucial missing link is the precise identification of mechanisms at the organ level that cause this physiological-biochemical...

BACKGROUND Critically ill patients may develop muscle weakness or paralysis during the course of sepsis and multiple-organ failure. We studied peripheral nerve and muscle disorders (NMD) in comatose patients. METHOD Comatose patients who developed paralysis associated with absent deep-tendon reflexes had electroneuromyography (ENMG) and muscle-nerve biopsy specimens taken. Onset and duration ...