Key Contacts
-
Dr. David McAlpineMBChB FCEM(SA) MMed
-
Dr. Jenna SpringMD, MASc, FRCPC
Resources Specific to Sinai Health ICU
These resources are specific to clinical situations you may encounter in the Sinai ICU. They are intended for ICU fellows or residents with substantial previous ICU exposure. For residents new to the ICU, we recommend focusing your learning on the general ICU concepts above.
We care for a large number of critically ill patients with cancer and frequently manage obstetrical emergencies (resources coming soon). For additional oncologic critical care resources, please visit the Critical Care Oncologic Investigative Network (COIN) website. Many of the resources contained in each topic below are from this website which is a collaborative between Sinai Health and Princess Margaret Cancer Centre.
Emergencies in Malignant Hematology
One Page Summaries:
Suggested Admission Orders:
- Suggested Admission Orders for Patients at High-Risk for or with Established Tumor Lysis Syndrome
- Suggested Admission Orders for Patients Presenting with Hyperleukocytosis and Leukostasis
- Suggested Admission Orders for Patients Presenting with Acute Promyelocytic Leukemia
Respiratory Failure in Immunocompromised Patients
Respiratory Failure in Immunocompromised Patients
Research and Review Articles
The following articles may also be helpful:
- JAMA – Association of Noninvasive Oxygenation Strategies With All-Cause Mortality in Adults With Acute Hypoxemic Respiratory Failure (Review in PDF downloaded from JAMA )
- Acute Respiroatroy Failure in patients with Hematologic Malignancies (Review in PDF downloaded from ClinicalKey)
- Acute respiratory failure in immunocompromised adults (Review in PDF downloaded from ClinicalKey)
Critical Illness in Patients on Novel Therapies
One Page Summaries
- Toxicities of CAR T-Cell Therapy: Cytokine Release Syndrome
- Immune-Related Adverse Events Associated with Immune-Checkpoint Inhibitors
Novel Cancer Therapies for the Intensivist - Dr. Bruno Ferreryo
Obstetrical Emergencies in Critical Care
Obstetric Critical Care
The new meropenem and piptazo extended infusion protocols
PRACTICE CHANGE: Meropenem and Piperacillin-Tazobactam Extended Infusion
- One Page Summary (Review in PDF download from Antimicrobial Stewardship)
- Prescriber Education Presentation (with audio)
Friday Fellows' Teaching: Previous Topics
Oncologic Critical Care
- Neurologic Complications in Patients with Hematologic Malignancies
- Pulmonary Complications Post-BMT
- Benefits of dexamethasone on early outcomes in patients with acute myeloid leukemia with hyperleukocytosis: a propensity score matched analysis – Ann He
- Extracorporeal membrane oxygenation in adults receiving haematopoietic cell transplantation: an international expert statement – Lancet Resp Med 2023
- Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia - NEJM 2023
- Hemophagocytic lymphohistiocytosis (HLH) in ICU
- Graft versus host disease
- Long-term survival and functional outcomes of critically ill patients with hematologic malignancies: a Canadian multicenter prospective study - ICM 2024
- Outcomes in Critically Ill Allogeneic HSCT Recipients
- Acute Respiratory Failure in patients with hematological malignancy: (No) time to catch a breath
- The Impact of Delayed Transition From Noninvasive to Invasive Mechanical Ventilation on Hospital Mortality in Immunocompromised Patients With Sepsis
- Idiopathic pneumonia syndrome
- Relationship between immunosuppression and intensive care unit-acquired colonization and infection related to multidrug-resistant bacteria: a prospective multicenter cohort study
Sepsis, Shock and Fluid Resuscitation
- Balanced Crystalloids vs. Saline in Critically Ill Adults – NEJM 2018
- Restriction of Intravenous Fluids in ICU Patients with Septic Shock – NEJM 2022
- Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit (LOVIT) – NEJM 2022
- Discussion: The Clovers Trial – NEJM 2023
- Fludrocortisone with Hydrocortisone in Septic Shock – JAMA Int Med 2023
- Lactate in septic shock
- Double Carbapenem Therapy for Multidrug-Resistant Organisms
- MERCY trial: Continuous vs Intermittent Meropenem – JAMA 2023
- Peripheral norepinephrine use
- Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis – NEJM 2022
- Anaphylaxis Management: Keep it in mind!
- Treatments for acute pulmonary embolism
- Fluid resuscitation in septic shock for patients at risk of volume overload
- Adjunctive Midodrine Therapy for Vasopressor-Dependent Shock in the ICU: A Systematic Review and Meta-Analysis - CCM 2025
- Methylene Blue in early sepsis?
- Effect of a resuscitation strategy targeting Peripheral perfusion vs Serum lactate in septic shock patients: The ANDROMEDA-SHOCK randomized clinical trial - JAMA 2019
- Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections - NEJM 2024
- Prolonged vs Intermittent Infusions of Antibiotics
- Retrospective Tertiary Care-Based Cohort Study on Clinical Characteristics and Outcomes of Ceftazidime-Avibactam-Resistant Carbapenem-Resistant Klebsiella pneumoniae Infections
- Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial
- Corticosteroids in septic shock
Respiratory Failure and Pneumonia
- Low-Dose Methylprednisolone in Patients with Severe Pneumonia (The ESCAPe Trial) – ICM 2022
- Long-Term Mortality and Health-Related Quality of Life of Lower vs. Higher Oxygenation Targets in ICU Patients with Severe Hypoxemia – ICM 2022
- A New Global Definition of ARDS – AJRCCM 2023
- Health Expectations and Quality of Life After Acute Respiratory Failure
- Inhaled amikacin to prevent ventilator-associated pneumonia
- A New Global Definition of Acute Respiratory Distress Syndrome
- High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial - JAMA 2024
- High flow nasal cannula oxygen therapy versus non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: a randomized controlled non-inferiority trial - Crit Care 2024
- Finding the optimal tidal volume in acute respiratory distress syndrome
- Corticosteroids in Sepsis, ARDS and CAP: Society of Critical Care Medicine, 2024 Focused Update - CCM 2024
- ICM April 2025 paper: Outcomes in immunocompromised patients with acute hypoxemic respiratory failure treated by high‑flow nasal oxygen.
- The use of salbutamol in ARDS as illustrated by the ALTA and BALTI-2 trials
Mechanical Ventilation and Airway Management
- The Difficult Airway Algorithm
- The Use of Ultrasound to Confirm Endotracheal Tube Placement
- Spontaneous-Breathing Trials with Pressure-Support Ventilation or a T-Piece
- Continued enteral nutrition until extubation compared with fasting before extubation in patients in the intensive care unit – Lancet Resp Med 2023
- A review of steroids for absent cuff leak and laryngeal edema
- Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults
- Adaptive Support Ventilation
- Peri-operative and Endobronchial TXA
- Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning
- Noninvasive Ventilation for Preoxygenation during Emergency Intubation
- Post-extubation respiratory failure
- Airway Occlusion Pressure As an Estimate of Respiratory Drive and Inspiratory Effort during Assisted Ventilation - AJRCCM 2020
- Tracheostomy Bleeding, A Case of The Dreaded Tracheo-Innominate Artery Fistula
- Frequency of Screening and Spontaneous Breathing Trial Techniques-A Randomized Clinical Trial
- Effect of Noninvasive Airway Management of Comatose patients with Acute Poisoning – A Randomized Clinical Trial
- Proportional-Assist Ventilation for Minimizing the Duration of Mechanical Ventilation
- Humidified Noninvasive Ventilation versus High-Flow Therapy to Prevent Reintubation in Patients with Obesity: A Randomized Clinical Trial
- Proportional-Assist Ventilation for Minimizing the Duration of Mechanical Ventilation
Post-Arrest and Cardiac Critical Care
- Guidelines for Post-Resuscitation Care
- Cooling Post-Cardiac Arrest: Is the debate settled?
- Angiography Post Out-Of-Hospital Cardiac Arrest – NEJM 2021
- Defibrillation Strategies for Refractory Ventricular Fibrillation – NEJM 2023
- Takotsubo Syndrome
- Two clinical cases highlighting key points regarding aortic disease
- Critical Care Considerations for patients with Fontan Circulation
- The 2023 AHA Updated CPR Guidelines on Cardiac Arrest After Poisoning
POCUS and Echocardiography
- VExUS score for grading of systemic venous congestion
- Using echocardiography to predict fluid-responsiveness and manage the need for fluids
- Bedside ultrasound in resuscitation
Sedation and Analgesia
- Haloperidol vs. placebo for the treatment of delirium in ICU patients: a pre-planned, secondary Bayesian analysis of the AID–ICU trial – ICM 2023
- Ketamine: The bountiful K-hole
- Ketamine – Should we be using it for multimodal pain therapy in the ICU?
- Comparative efficacy of non-pharmacological interventions for anxiety in adult intensive care unit patients: A systematic review and network meta-analysis
- A2B trial on sedation strategies in the ICU
Neurocritical Care and Neurology
- Rapid Guideline/Position Statement Updates: Brain-Based Definition/Determination of Death, and Neuroprognostication after Cardiac Arrest – Can J Anes 2023
- A short review on the differential for Rapidly Progressive Dementia, with a focus on CJD.
- Ceftriaxone to prevent early VAP in patients with traumatic brain injury
- The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3):an international, stepped wedge cluster randomised controlled trial - Lancet 2023
- Liberal or Restrictive Transfusion Strategy in Patients with Traumatic/Acute Brain Injury
- Cognitive Motor Dissociation in Disorders of Consciousness
Acute Kidney Injury, Renal Failure, Topics in Nephrology
- Do we believe in Myths?: “Renal outcomes following intravenous contrast administration in patients with acute kidney injury: a multi-site retrospective propensity-adjusted analysis“
- Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis – NEJM Evidence 2023
- Let it flow: Acetazolamide in the 21st century
- Correction Rates and Clinical Outcomes in Hospitalized Adults With Severe Hyponatremia: A Systematic Review and Meta-Analysis - JAMA Int Med 2024
Obstetric Critical Care
Surgical Critical Care
- Leeches in ICU, Should I be Concerned?
- Post -Op Free Flaps: fluids vs pressors
- Abdominal Compartment Syndrome
Goals of Care, Long-Term Outcomes, Post-ICU Care
- Family Response to Critical Illness: Post-intensive care syndrome in caregivers – CCM 2012
- What lies under the rubble: complicated grief following death of a loved one in ICU
- Post ICU: A Journey of Recovery?
- A Randomized Trial of Shared Decision-making in Code Status Discussions
Miscellaneous
- Selective Decontamination of the Digestive Tract in Intensive Care Unit Patients (SUDDICU) – JAMA 2022
- Total parenteral nutrition (TPN)/Supplemental parenteral nutrition in the ICU
- Hyperammonemia in Critically Ill Patients
- A review on current knowledge on gut microbiota in critical illnesses
- Inflammatory biomarkers as predictors for ICU admission and adverse outcomes
- Good Vibes Only: Pitfalls of the Blood Pressure Cuff
- Multi Inflammatory Syndrome
- “Crikey!: snakebite envenomation for the non-Australian intensivist (and other animals that can kill you)”
- A trial with stress ulcer prophylaxis
- Reassessing the need for scheduled replacement of short-term central venous catheters: A narrative comprehensive review
- Intravascular Complications of Central Venous Catheterization by Insertion Site
- An alternate for methylene blue: high-dose IV hydroxycobalamin (Vitamin B12) in refractory distributive shock
- Review of Cardiac Obstetrics
- Inhaled Sedation in ARDS
- Pressor Targets and OPTPRESS TRIAL
- Primary Results of the PEERLESS Randomized Controlled Trial
- The influence of positive pressure ventilation on renal function
- Hospital-Wide Implementation, Clinical Outcomes, and Safety of Phenobarbital for Alcohol Withdrawal
- Scoring Systems in the ICU
- Angiotensin ll in Vasodilatory Shock
- The Use of Esophageal catheter to regulate PEEP
- Effect of Hydrocortisone on Mortality in Patients with Severe Community-Acquired Pneumonia: The REMAP-CAP Corticosteroid Domain Randomized Clinical Trial
- Albumin resuscitation in sepsis and septic shock
- Diagnosis of severe respiratory infections in immunocompromised patients- The DIRECT framework
- Mixed vasodilatory-cardiogenic shock: current insights and practice
- Space Physiology in ICU
- Cardiogenic shock - contemporary challenges and opportunities
- Deferring Arterial Catheterization in Critically Ill Patients with Shock.
- Corticosteroids in septic shock
- Peripheral Vasopressor Use in Early Sepsis-Induced Hypotension
- Use of melatonin in the prevention of delirium
- Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults
- Introduction to resuscitative TEE
- PICS (Post ICU Syndrome): Critical Care associated disease and Opportunities for Prevention.
- Use of melatonin in the prevention of delirium
- Introduction to resuscitative TEE
- PICS (Post ICU Syndrome): Critical Care associated disease and Opportunities for Prevention.
- Setting PEEP using electrical impedance tomography
- Using TTE as a Swan-Ganz catheter
- HELLP/DIC/TTP/AFLP
- Lactate in ICU
- Utility of Biomarkers to guide antimicrobial therapy
- Steroids in Critical Care Medicine
- The EVERDAC trial with an introduction about shock in general
- The ICU Hangover: Understanding Post-Intensive Care Syndrome
- Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism
- The SOHO trial: is it all about mortality?
- Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock
- RCT on using IPC to reduce the incidence of upper extremity venous thrombosis after PICC placement in TBI patients
- Sodium Bicarbonate forSevere Metabolic Acidemia And AcuteKidneyInjury
The BICARICU-2 Randomized ClinicalTrial