United States organ procurement organizations increasingly are centralizing the management and recovery of organs from deceased donors into dedicated donor care units (DCUs) with growing evidence of effectiveness. This paradigm shift offers logistical advantages, but introduces new considerations for intensivists responsible for the safe, effective, and efficient management of deceased potential organ donors. In this How I Do It article, intensivist leaders of 12 US DCUs collaborating in the Donor Care Unit Networ…

Abstract Background In acute respiratory distress syndrome (ARDS), respiratory drive often differs among patients with similar clinical characteristics. Readily observable factors like acid–base state, oxygenation, mechanics, and sedation depth do not fully explain drive heterogeneity. This study evaluated the relationship of systemic inflammation and vascular permeability markers with respiratory drive and clinical outcomes in ARDS. Methods ARDS patients enrolled in the multicenter EPVent-2 trial with requisite d…

Over the past 2 decades, clinical management and recovery of organs from deceased donors in the United States increasingly have been centralized into specialty donor care units. Intensivists who lead or practice in donor care units colocated with hospitals (or hospital-based donor care units) are well positioned to offer operational experience, to deliver evidence-based clinical donor management, and to leverage hospital resources to facilitate research and education efforts to improve access to transplantable org…

Abstract Background The objective was to compare sevoflurane, a volatile sedation agent with potential bronchodilatory properties, with propofol on respiratory mechanics in critically ill patients with COPD exacerbation. Methods Prospective study in an ICU enrolling critically ill intubated patients with severe COPD exacerbation and comparing propofol and sevoflurane after 1:1 randomisation. Respiratory system mechanics (airway resistance, PEEPi, trapped volume, ventilatory ratio and respiratory system compliance)…

OBJECTIVES: Although patients in the ICU are closely monitored, some ICU cardiac arrest events may be preventable. In this study, we sought to reduce the rate of cardiac arrests occurring in the ICU through a quality improvement initiative. DESIGN: Prospective, observational study. SETTING: ICUs of a single tertiary care center. PATIENTS: Patients hospitalized in the ICUs between August 2017 and November 2019. INTERVENTIONS: A comprehensive trigger and response tool. MEASUREMENT AND MAIN RESULTS: Forty-three patie…