An 81-year-old man had had mild dysphagia for several years. During the six months before admission, the dysphagia worsened, and he had occasional hemoptysis. For several days before admission he… View full post on NEJM — Collection Updates for Critical Care

Background: Recent outbreaks of avian influenza A (H5N1) in poultry throughout Asia have had major economic and health repercussions. Human infections with this virus were identified in Vietnam in January… View full post on NEJM — Collection Updates for Critical Care

Acute adrenal insufficiency, a rare cause of shock, is manifested as shock that is poorly responsive to fluid resuscitation and pressors, not unlike cardiogenic or septic shock. It is almost… View full post on NEJM — Collection Updates for Critical Care

Background: Because more than 90 percent of circulating cortisol in human serum is protein-bound, changes in the binding proteins can alter measured serum total cortisol concentrations without influencing free concentrations… View full post on NEJM — Collection Updates for Critical Care

A 47-year-old man was admitted to the intensive care unit with respiratory failure complicating pneumonia due to legionella infection. Mechanical ventilation with positive end-expiratory pressure was initiated. Radiographs of the… View full post on NEJM — Collection Updates for Critical Care

A 17-year-old girl was involved in a car accident as a passenger. Before she was transported by helicopter to a hospital, a central venous catheter was inserted. She was admitted… View full post on NEJM — Collection Updates for Critical Care

Background: It remains uncertain whether the choice of resuscitation fluid for patients in intensive care units (ICUs) affects survival. We conducted a multicenter, randomized, double-blind trial to compare the effect… View full post on NEJM — Collection Updates for Critical Care

The Saline versus Albumin Fluid Evaluation (SAFE) Study, reported in this issue of the Journal,1 heralds a new era in critical care marked by the large, simple, randomized trial popularized… View full post on NEJM — Collection Updates for Critical Care