Tag: surgery

Upvote Story 5
This case report shows that junctional rhythm can cause deterioration of SAM, LVOTO, and MR, and can lead to unstable hemodynamics in a patient with right ventricular failure after MVR. Atrial pacing can resolve SAM, LVOTO, and MR and can improve hemodynamics in a patient with unstable normal sinus rhythm. TEE in the ICU can play a pivotal role in clinical decision-making. Given that there... Read More | Comment
Upvote Story 3
During a period of service reconfiguration, intensivists routinely rostered to work in one ICU worked in another of the hospital's four ICUs. "Home" intensivists were those who continued to work in their usual ICU; "visitor" intensivists were those who delivered care in an unfamiliar ICU. Patient data were obtained from electronic patient records to provide analysis on sex, age, admission Sequential Organ Failure Assessment score,... Read More | Comment
Upvote Story 13
Acute kidney injury (AKI) is a frequent postoperative complication with a substantial risk for both short and long-term adverse events, and its incidence is likely to rise because of increasing major surgical procedures. Studies investigating better strategies to prevent and treat AKI in this population are urgently needed.Postoperative AKI affects approximately one-fifth of patients after major surgery, but the incidence varies according to the type... Read More | Comment
Upvote Story 11
Aged, critically ill surgical patients have greater organ dysfunction and incidence of adverse clinical outcomes after sepsis. Biomarker profiles suggest an immunophenotype of persistent immunosuppression and catabolism. Advanced age may necessitate novel therapeutic strategies to promote multisystem organ recovery and improve survival after sepsis. The cohort included 173 patients with severe sepsis (n = 93; 53.8%) or septic shock (n = 80; 46.2%), with a... Read More | Comment
Upvote Story 13
Recently released, Abdominal Sepsis examines in detail the topic of sepsis, with a focus on intra-abdominal sepsis. Particular attention is devoted to source control in the management of the infection, antimicrobial therapy and sepsis support, which represent the cornerstones of treating patients with this problem. The importance of a multidisciplinary approach is highlighted not only by the instructive and informative sections on the acute manifestations... Read More | Comment
Upvote Story 4
In this compelling episode, Professor Paul Wischmeyer, shares some of his experiences as a patient in the ICU. Since he was 15 he has endured multiple hospitalizations and ICU stays for his inflammatory bowel disease. This has given him an excellent vantage point to notice what we as ICU professionals do and say to our patients. And from Paul’s perspective we could do much better.... Read More | Comment
Upvote Story 7
We instituted several interventions in our trauma and surgical ICU aimed at improving communication and teamwork between RNs and MDs. Informal feedback indicated greater satisfaction among RNs and MDs with the working environment. However, these results were not reproduced on a subsequent national survey, reflecting the difficulty of measuring intervention effectiveness using standardized surveys. The fundamental elements of our approach that may be used in... Read More | Comment
Upvote Story 15
Doctors have gradually come to realize that people who survive a serious brush with death in the intensive care unit are likely to develop potentially serious problems with their memory and thinking processes. This dementia, a side effect of intensive medical care, can be permanent. And it affects as many as half of all people who are rushed to the ICU after a medical emergency.... Read More | Comment
Upvote Story 11
Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of energy to provide, the route to choose and how to adapt according to various clinical conditions. When to... Read More | Comment
Upvote Story 6
This study suggests that with triiodothyronine (T3) supplementation there was evidence of serum free T3 normalization without evidence of associated harms. A definitive trial is needed to evaluate clinical effectiveness. Data were extracted from the medical records of 70 consecutive patients. All had baseline serum free T3 concentrations below the lower limit of our laboratory’s reference range and 22 (31%) patients also had low thyroxine... Read More | Comment
Upvote Story 16
A restrictive transfusion threshold is recommended in nearly all critically ill patients. This is at least noninferior to more liberal transfusion practice; in addition, a restrictive threshold has shown improved outcomes in some patients and decreased chances of adverse events in patients. Judicious use of red cells improves patient outcome and protects the blood supply, a limited resource. More data are needed to determine appropriate... Read More | Comment
Upvote Story 23
Blue Collar, Blue Scrubs turns back the clock, taking readers from his days as a construction worker to his entry into medical school, expertly infusing his journey to become a doctor with humanity, compassion, and humor. From the first time he delivers a baby to being surrounded by death and pain on a daily basis, Collins compellingly writes about how medicine makes him confront, in... Read More | Comment
Upvote Story 5
Although thiamine would not be isolated until 1911, the clinical syndrome of thiamine deficiency was recognized as far back as 2700 BC, when the term “beriberi”, meaning “wasted wasted” was first coined in China. Nearly 5,000 years later in the 1800’s, a Japanese naval surgeon discovered that death rates among sailors plummeted when they ate a nutritious and varied diet instead of mainly white rice,... Read More | Comment
Upvote Story 5
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