Tag: oxygenation
Integration Equals Separation for CRRT Filter Lifespan in ECMO Patients (E-CRRT Trial)
The multicenter randomized controlled E-CRRT Trial, conducted from May 2021 to March 2025 at King Chulalongkorn Memorial Hospital (KCMH) and Central Chest Institute of Thailand (CCIT), compared two strategies for combining... read more
Taming the Physiologically Difficult Airway: Safer Intubation in Critically Ill Adults
Tracheal intubation is a frequent and high-risk procedure in critically ill adults, with a global study of nearly 3,000 patients revealing major peri-intubation adverse events in 45% of cases—primarily cardiovascular collapse... read more
Refining Neuromuscular Blockade Use in ARDS
Acute Respiratory Distress Syndrome (ARDS) remains a critical challenge in medicine, persistently linked to mortality rates exceeding 30% despite extensive research over the years. The lack of effective drug treatments means... read more
Ventilator Management: A Pre-Hospital Perspective
The goal of this book is to provide the most up to date information on mechanical ventilation based on current research, evidence based practice and my experiences as a flight paramedic and educator. A comprehensive look... read more
VV-ECMO Wins Big: Twice the Survival Odds Over VA-ECMO in Respiratory Failure
A PRISMA-guided systematic review and meta-analysis of 11 studies involving 3,598 patients with severe respiratory failure found that veno-venous ECMO (VV-ECMO) is linked to significantly better survival to hospital discharge... read more
Mastering Non-Invasive Respiratory Support: A Guide to Success
This clinical guide provides an overview of non-invasive respiratory support (NIRS) techniques—including High-Flow Nasal Therapy (HFNT), Continuous Positive Airway Pressure (CPAP), and Bilevel Positive Airway Pressure (BiPAP)-for... read more
SOFA-2: Close, But Not Quite the Ideal Measure of Organ Failure
The SOFA-2 (Sequential Organ Failure Assessment) score represents the latest effort to provide a simple, reliable, and continuous measure of organ dysfunction in critically ill patients, a concept first outlined decades ago.... read more
The Vitamin C Verdict: Not a COVID-19 Mortality Fix
This systematic review and meta-analysis investigated the efficacy of Vitamin C as a treatment for COVID-19, focusing on key patient outcomes like mortality and critical care resource utilization. Objective: To determine... read more
The Sepsis Chain of Survival: Breaking the Cycle
This framework offers a systematic and adaptable approach to improving outcomes for patients with suspected sepsis. Borrowing from the successful Cardiac Arrest Chain of Survival, the Sepsis Chain emphasizes a seamless series... read more
Voice Breakthrough: Bringing Speech Back to Ventilator Patients
This retrospective cohort study investigated the safety and success of placing a speaking valve in-line with the mechanical ventilator circuit for critically ill, tracheostomized patients who struggled to wean from the ventilator. Study... read more
The Hidden Danger of Insufficient Sedation in ARDS
This prospective observational study highlights a critical issue in the Intensive Care Unit (ICU): a substantial number of patients with Acute Respiratory Distress Syndrome (ARDS) receiving continuous neuromuscular blockade... read more
A Shift in Strategy: Rethinking Blood Transfusions for Brain Injury
Recent clinical trials have challenged the standard practice of using a restrictive Red Blood Cell (RBC) transfusion strategy for critically ill brain-injured patients (ABI). Restrictive Approach is Questioned: The prevailing... read more
More Than Just Acid: Navigating the Complexities of Lactate in Critical Care
Lactate is a vital marker in critical care, but its meaning is complex, reflecting an interplay of perfusion, metabolism, organ function, and stress. Clinicians must adopt a nuanced, multimodal approach to interpretation,... read more
ECMO-Extracorporeal Life Support in Adults
Extracorporeal membrane oxygenation (ECMO) has been in clinical use for some 40 years, but it is only in the past decade that its application in the treatment of life-threatening circulatory and respiratory failure has truly... read more
Predicting Mortality in Sepsis-Related ARDS Using Machine Learning
The application of machine learning methodologies to construct prognostic prediction models for sepsis patients complicated by ARDS, informed by the new global definition, proves to be reliable. This approach can assist clinicians... read more
Endotracheal Intubation Preoxygenation in Resource-limited Settings
Optimal preoxygenation strategies for endotracheal intubation (ETI) in LRS require both protocol adaptation and clinical resourcefulness. An individualized approach using the most feasible combination of techniques should... read more
Rib-Indexed POCUS vs. Chest X-Ray for Lung Recruitment Assessment in Ventilated Neonates with Moderate-Severe ARDS on Pulmonary Surfactant Therapy
Rib-indexed posterior approach POCUS is a reliable, radiation-free modality for real-time lung recruitment assessment in neonates with NARDS, demonstrating noninferiority to CXR. Notably, our study is the first to propose... read more
Causes of Death in Patients Undergoing ECPR
Refractory shock was the leading cause of death among our cohort of extracorporeal cardiopulmonary resuscitation (ECPR) patients, followed closely by neurological complications, while other causes are rare. In this post-hoc... read more
Mechanical Power Impact Normalized to Predicted Body Weight on Outcomes in Pediatric ARDS
Higher mechanical power (MP) was associated with fewer ventilator (VFD) and ICU free days (IFD). The causal effect of MP on VFD and IFD was fully mediated by the impairment in oxygenation. This is a post-hoc analysis of... read more
Clinical Respiratory Anatomy and Physiology in the ICU: Anatomophysiopathology and gasometry of patients on invasive mechanical ventilation
Breathing is a physiological process that is fundamental to life. The respiratory system can be likened to a vital pump allowing the exchange of gases between the cells of an organism and the external environment. A number... read more
VA-ECMO and Pulmonary Reperfusion
The study by Stadlbauer and colleagues provides further evidence that veno-arterial extracorporeal membrane oxygenation (VA-ECMO) should—whenever necessary—be used, as a bridge to pulmonary reperfusion, but not as a bridge... read more
ECMO in the Adult Patient (Core Critical Care)
Extracorporeal membrane oxygenation (ECMO) is developing rapidly, and is now part of the toolkit for the management of all patients with severe respiratory or cardiac failure. Clinicians of all disciplines are in need of... read more
