Major publications in critical care pharmacotherapy literature in 2018.

PURPOSE: To summarize selected original critical care pharmacotherapy research published in 2018. MATERIALS AND METHODS: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 32 journals monthly for impactful articles and reviewed 100 articles during 2018. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria were applied to all relevant articles included in the monthly CCPLU. Articles with a 1A grade, including one clinical practice guideline, two meta-analyses, and ten original research trials, were selected for review. RESULTS: Clinical practice guidelines for the management of pain, agitation, delirium, immobility, and sleep disruption were summarized. Meta-analyses on the role of corticosteroids in sepsis and early enteral nutrition were reviewed. Included original research trials evaluated corticosteroids in sepsis, enteral and parenteral nutrition in patients with shock, tenecteplase in acute ischemic stroke, antipsychotics for the treatment of intensive care unit delirium, vasopressors in cardiogenic shock, balanced crystalloids and saline for fluid administration, and meropenem and piperacillin-tazobactam for treatment of resistant Gram-negative organisms. CONCLUSION: This clinical review and expert commentary of impactful critical care pharmacotherapy publications in 2018 provides perspectives and insights for the critical care practitioner