Recent Critical Care News

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This book discusses mechanical ventilation in emergency settings, covering the management of patients from the time of intubation until transfer to the ICU. It provides an introduction to key concepts of physiology pertinent to mechanical ventilation as well as a review of the core evidence-based principles of ventilation. The text highlights the management of mechanical ventilation for critically ill patients with several conditions commonly encountered... Read More | Comment
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Recent studies suggest that hypotension thresholds in current guidelines might be too low for older patients due to arterial stiffening, possibly leading to insufficient fluid resuscitation. We compared intravenous (IV) fluid volumes that older (≥ 70 years) and younger ( Read More | Comment
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This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the non-inferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in pregnant women and outside the operating room. Although this study failed to demonstrate non-inferiority of sham cricoid pressure to cricoid pressure the data does not show any hint that cricoid pressure is the better approach.... Read More | Comment
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The efficacy of corticosteroid use in acute respiratory distress syndrome (ARDS) remains controversial. Generally, short-term high-dose corticosteroid therapy is considered to be ineffective in ARDS. On the other hand, low-dose, long-term use of corticosteroids has been reported to be effective since they provide continued inhibition of the systemic inflammatory response syndrome (SIRS) that accompanies ARDS. Thus far, no reports have been published on the efficacy... Read More | Comment
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Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely accepted that the utilization of lung-protective ventilation reduces ventilator-associated complications including acute respiratory distress syndrome (ARDS). Additionally, it is believed that ventilatory-associated lung injury can occur early after the... Read More | Comment
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This book collects and synthesizes the latest thinking on the condition in its variety of cognitive and behavioral presentations, matched by a variety of clinical responses. Acknowledging the continuum of injury and the multi-stage nature of recovery, expert contributors review salient research data and offer clinical guidelines for the neuropsychologist working with TBI patients, detailing key areas of impairment, brief and comprehensive assessment methods and... Read More | Comment
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Critically ill patients with subarachnoid hemorrhage show a strong association between hyperchloremia and acute kidney injury as well as acute kidney injury and mortality. Of 1,267 patients included in this cohort, 16.7% developed acute kidney injury, as defined by Kidney Disease Improving Global Outcome criteria (changes in creatinine only). Compared to patients without acute kidney injury, patients with acute kidney injury had a higher prevalence... Read More | Comment
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Hospital-acquired infections (HAIs) result in excess morbidity, mortality, and resource consumption. Immobilized, ventilator-dependent ICU patients are at the highest risk of HAI. Despite broad implementation of relevant bundles, HAI incidence in our neuro ICU remained high, particularly catheter-associated urinary tract infections (CAUTIs) and ventilator-associated events (VAEs). We reviewed the administrative data and nosocomial infection markers (NIMs) for all neurology and cranial neurosurgery patients admitted to... Read More | Comment
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The high cost of critical care has engendered research into identifying influential factors. However, previous studies have not considered patient vital status at ICU discharge. This is what a new study has found: The largest drivers of ICU costs at the patient level are day 1 room occupancy and day 1 mechanical ventilation, and mortality before unit discharge is associated with substantially higher costs. Read More | Comment
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Guiding FFICM and EDIC exam candidates through the intensive care medicine curriculum, this book provides 48 case studies mapped to eight key areas of study in the UK and European syllabuses. Cases include clinical vignettes, explanations and a list of key learning points, while also being formatted along the structure of FICM case reports. Key clinical management points are identified and linked to appropriate scientific... Read More | Comment
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Patients who survive acute respiratory distress syndrome (ARDS) often leave ICU with debilitating mental, physical, or cognitive problems that may limit their quality of life. These challenges are called post-intensive care syndrome (PICS). The survivors may live with long-term effects, including permanent lung damage and different degrees of physical, cognitive, and mental health problems. Now, a new study of 645 ARDS survivors by researchers at... Read More | Comment
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The team of nurses that Tilda Shalof found herself working with in the intensive care unit (ICU) of a big-city hospital was known as “Laura’s Line.” They were a bit wild: smart, funny, disrespectful of authority, but also caring and incredibly committed to their jobs. Laura set the tone with her quick remarks. Frances, from Newfoundland, was famous for her improvised recipes. Justine, the union... Read More | Comment
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A high-flow nasal cannula (HFNC) is a high-flow oxygen supply device developed in recent years and is increasingly being used to treat acute hypoxemic respiratory failure (AHRF) in intensive care unit (ICU). Patients with pre-existing chronic lung disease (CLD) often develop AHRF and require ICU admission. HFNC therapy is also used for these patients in clinical practice, although few studies have examined its efficacy. We... Read More | Comment
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Thromboelastography (TEG) seems to be safely used to guide anticoagulation management during ECMO. Its use was associated with the administration of lower heparin doses compared to a standard of care aPTT-based protocol. Forty-two patients were enrolled: 21 were randomized to the TEG group and 21 to the aPTT group. Duration of ECMO was similar in the two groups (9 (7–16) days in the TEG group... Read More | Comment
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This trial provides evidence that a strategy of avoiding continuous sedation as early as possible, in the absence of residual neuromuscular blockade and hypothermia, compared with usual sedation care, resulted in improvements in several important clinical outcomes in critically ill postoperative patients. Given the clinical and economic burden of critical illness, postoperative morbidity, and the substantial number of patients who could benefit from this strategy,... Read More | Comment