Impact of Pharmacists to Improve Patient Care in the Critically Ill: A Large Multicenter Analysis Using Meaningful Metrics With the Medication Regimen Complexity-ICU (MRC-ICU) Score.

Objectives: Despite the established role of the critical care pharmacist on the ICU multiprofessional team, critical care pharmacist workloads are likely not optimized in the ICU. Medication regimen complexity (as measured by the Medication Regimen Complexity-ICU [MRC-ICU] scoring tool) has been proposed as a potential metric to optimize critical care pharmacist workload but has lacked robust external validation. The purpose of this study was to test the hypothesis that MRC-ICU is related to both patient outcomes and pharmacist interventions in a diverse ICU population.

Front-Loaded Versus Low-Intermittent Phenobarbital Dosing for Benzodiazepine-Resistant Severe Alcohol Withdrawal Syndrome.

Introduction: Phenobarbital is frequently used to manage severe alcohol withdrawal. The purpose of this study was to compare the incidence of mechanical ventilation in patients with benzodiazepine-resistant alcohol withdrawal between front-loaded and low-intermittent phenobarbital dosing strategies.

Methods: In this retrospective before-after study, we analyzed patients that received phenobarbital for severe alcohol withdrawal syndrome in a tertiary medical ICU.

Adjunctive Use of Ketamine for Benzodiazepine-Resistant Severe Alcohol Withdrawal: a Retrospective Evaluation.

Introduction: Benzodiazepine (BZD)-resistant alcohol withdrawal remains a challenge for most institutions due to limited evidence with available agents. One published study currently exists utilizing the N-methyl-D-aspartate antagonist, ketamine, for alcohol withdrawal.

Objective: The purpose of our study was to evaluate the effect of adjunctive ketamine continuous infusion on symptom control and lorazepam infusion requirements for BZD-resistant alcohol withdrawal patients in the intensive care unit.

Correlation Between Partial Pressure of Arterial Carbon Dioxide and End Tidal Carbon Dioxide in Patients with Severe Alcohol Withdrawal.

Background: Respiratory depression is a common adverse effect of benzodiazepine administration to patients with severe alcoholic withdrawal. This study was conducted to assess the value of end tidal carbon dioxide (ETCO2) levels compared to partial pressure of arterial carbon dioxide (PaCO2) levels in monitoring respiratory depression secondary to benzodiazepine treatment in patients with severe alcohol withdrawal.

Methods: We retrospectively analyzed 36 patients admitted to the intensive care unit for severe alcohol withdrawal who had been administered sedative agents.

Addition of vasopressin to norepinephrine as independent predictor of mortality in patients with refractory septic shock: an observational study.

Objective: To identify predictors of 28-day mortality among patients with refractory septic shock treated with norepinephrine with or without vasopressin.

Design: Prospective observational cohort study.

Setting: A 1,200-bed academic medical center.