"Finding the Right Dose: Optimizing Drug Therapy in Critically Ill Patients With Obesity" by Lauren Finch, PharmD; Carolyne DaSilva, PharmD; and Uyen Diep, PharmD, BCCCP, FCCM (AACN Advanced Critical Care, Fall 2026;37:265-271; Drug Update column edited by Melissa Noble, PharmD, BCCCP, FCCM) reviews how obesity alters pharmacokinetics/pharmacodynamics in the ICU and offers drug-class–specific dosing and monitoring guidance. Roughly 20% of ICU patients have obesity, and excess

Summary: "Pharmacotherapy Considerations for Inpatient Advanced Cardiac Life Support" (Posgai & Hochstetler, AACN Advanced Critical Care, 2025) This review addresses medication management in adult cardiac arrest, emphasizing that despite decades of use, no drug has been proven to improve survival with favorable neurologic outcome. Survival to discharge remains low—9.1% for out-of-hospital and 18.8% for in-hospital arrest—with high-quality CPR and early defibrillation of shock

Negative vs. positive pressure ventilation Negative pressure devices (iron lung, cuirass) expand the chest externally and are mainly useful in neuromuscular disease but cannot precisely control ventilation. Positive pressure ventilation delivers gas via a cuffed tube or mask, allows precise control of ventilation/oxygenation, and is the critical care standard. The three components of a ventilator mode Breath control variable — every mode is either: Volume control (VC): VT is

Titrating drips in the critical care environment can be one of the most exciting things a nurse can do, but also one of the scariest. Drip titration requires critical thinking, autonomy, confidence, and a deep knowledge of the medications. What is drip titration? Titratable drips are medications that are ordered by an LIP, and the dosing is determined by the nurse, based on a set of parameters. Titratable drips can vary from vasopressors, paralytics, sedatives, inotropes, in

The purpose of these drugs is to increase blood pressure Norepinephrine (LEVOPHED) Alpha 1 and Beta 1 agonist Ideal for septic shock/cardiogenic shock Should be given through a central line, although okay to give peripherally for a short term Not the best drug to use as a 'push' dose Phenylephrine (NEO) Alpha 1 agonist Ideal for sedation related hypotension Also useful in hypotension related to tachycardic states Can be given push dose routinely Vasopressin Works on vasopress

Types of Airways in the ICU In the Intensive Care Unit (ICU), various types of airways are utilized to ensure adequate ventilation and oxygenation of patients. The primary types include supraglottic airways, tracheostomies, endotracheal tubes, and bag valve masks. Each type has its specific indications, benefits, and limitations. 1. Supraglottic Airways Supraglottic airways are devices that are inserted into the pharynx to maintain an open airway and facilitate ventilation