NIPPV is frequently used in the management of critically ill patients presenting with an acute COPD exacerbation, as NIPPV decreases the rates of intubation and is associated with lower in-hospital mortality. Typically, "low" intensity NIPPV, whereby inspiratory positive airway pressures less than 18 cm H2O are used. More recently, the use of "high" intensity NIPPV, with IPAPs between 20-30 cm H2O, has been shown to improve gas exchange, ventilatory function, and improve arterial PCO2 values. In this podcast, we review the HAPPEN Trial, which compared low intensity to high intensity NIPPV on the need for intubation in patients with an acute COPD exacerbation and hypercapnia.

The incidence of opioid-associated out-of-hospital cardiac arrests continues to rise. Current guidelines for the resuscitation of patients with OHCA advise the clinician to consider the administration of naloxone of patients with suspected opioid-associated OHCA. In this podcast, we review a recenlty published study in JAMA that evaluated the association of naloxone with patient outcomes in opioid-associated OHCAs.

Timely administration of broad-spectrum antibiotics is a critical pillar in the resuscitation of patients with sepsis. B-lactam antibiotics are an important class of antibiotics commonly administered to patients with sepsis. Typically, B-lactam antibiotics are administered over 30 minutes, but optimal bactericidal activity requires the concentration of free drug to be above the MIC of the organism for 40-70% of the dosing interval. In this podcast we discuss two recent publications that compare continuous infusions of B-lactam antibiotics with intermittent effusions in patients with sepsis.