Protocolized Fluid Balance Neutralization During CRRT

Bitker et al. report the GO NEUTRAL randomized clinical trial results, which investigated fluid balance neutralization guided by functional hemodynamic monitoring (FHM) protocol versus a standard of care in critically ill... read more

Preventing VAP Non-Pharmacologically

In critically ill, intubated patients on intensive care unit (ICU), ventilator-associated pneumonia (VAP) is a significant complication contributing to substantial mortality, morbidity, and prolonged stays, which in turn... read more

ARDS and Prone Positioning

Prone positioning has been a treatment option for acute respiratory distress syndrome in critically ill patients. Since the COVID-19 pandemic, awake prone positioning has been utilized as a treatment option for non-intubated... read more

Management of Refractory COPD

Chronic obstructive pulmonary disease (COPD) is a common condition with an estimated global prevalence of almost 12 percent in adults over age 30 years [1-3]. Prior to the onset of the COVID-19 (coronavirus disease 2019)... 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

Ventilator Management: A Pre-Hospital Perspective

Oxygen Therapy and Noninvasive Respiratory Supports in Acute Hypoxemic Respiratory Failure

Whereas oxygen supplementation should be initiated for patients with acute hypoxemic respiratory failure defined as PaO2 below 60 mm Hg or SpO2 ... read more

Optimizing Oxygenation For Tracheal Intubation in Critically Ill Patients

Tracheal intubation (TI) is a common procedure frequently performed in critically ill patients and is an integral part of emergency airway management (EAM). However, it carries inherent risks and can significantly impact... read more

Veno-Arterial-Venous ECMO in a Patient Undergoing Dialysis and Having Cardiopulmonary Failure Due to COVID-19

COVID-19 can cause cardiomyopathy, a rare cardiovascular disorder that can lead to cardiogenic shock. The cardiac and respiratory symptoms may not occur simultaneously, and it is possible to switch to veno-arterial-venous... read more

Oxygen Therapy in Acute Hypoxemic Respiratory Failure

Although largely used, the place of oxygen therapy and its devices in patients with acute hypoxemic respiratory failure (ARF) deserves to be clarified. The French Intensive Care Society (Société de Réanimation de Langue... read more

Conservative or Liberal Oxygen Targets in Patients on VA-ECMO

In adults receiving VA-ECMO in the ICU, a conservative compared to a liberal oxygen strategy did not affect the number of ICU-free days to day 28, nor any other measurable patient outcomes up to 6 months after ICU admission.... read more

Predictors of High-flow Nasal Cannula Failure in COVID-19 Patients

A retrospective cohort study was conducted during the months of March and May 2021. Data collection was based on a follow-up of 156 hospitalized patients with a diagnosis of COVID-19 who were users of high-flow nasal cannula... read more

How does high fowlers position help with ventilation?

The High Fowler's position, characterized by an inclination of 60-90 degrees, significantly enhances ventilation by optimizing lung expansion and improving respiratory mechanics. This position is particularly beneficial for... read more

Early Reapplication of Prone Position During VV-ECMO for ARDS

A combination of prone positioning (PP) and venovenous extracorporeal membrane oxygenation (VV-ECMO) is safe, feasible, and associated with potentially improved survival for severe acute respiratory distress syndrome (ARDS).... read more

Glucose Metabolism Disorders: Pre-hospital Oxygen Therapy and Saturation Variability in COVID-19 Patients

The COVID-19 pandemic has revealed that viruses can have multiple receptor properties, penetrating various tissues and causing mutations in various genes, thus promoting a range of metabolic disorders. The purpose of... read more

Pitfalls in the Management of Mechanical Ventilation: ARDS and Hypermetabolic States

Mechanical Ventilation (MV) is an invaluable, lifesaving therapy for patients with acute respiratory failure, but it must be individualized for each specific underlying physiologic derangement to maximize benefits and minimize... read more

Pressure Support Ventilation During ECMO Support in Patients with ARDS

In the initial phases of veno-venous extracorporeal membrane oxygenation (VV ECMO) support for severe acute respiratory distress syndrome (ARDS), ultraprotective controlled mechanical ventilation (CMV) is typically employed... read more

Emergency and Prophylactic ECMO for Patients Undergoing Valve-in-Valve Transcatheter Aortic Valve Implantation with Small Surgical Bioprosthesis

Mechanical circulatory support (MCS) using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is widely implemented as a rescue device in transcatheter aortic valve implantation (TAVI). Although prophylactic... read more

Lower or Higher Oxygenation Targets in the ICU

This study reported no overall differences comparing a PaO2 target of 8–12 kPa on mortality or days alive without life support in 90 days. Subgroup analyses suggested heterogeneity of treatment effects (HTE) in patients... read more

High-flow Nasal Cannula Oxygen vs. NIV in AHF-related ARF

In this pilot study, we did not observe a statistically significant difference in changes in respiratory rate among patients with acute respiratory failure (ARF) due to acute heart failure (AHF) and managed with high-flow... read more

Prevalence and Survival of Prolonged VV ECMO for ARDS

The understanding of prolonged venovenous extracorporeal membrane oxygenation (VV ECMO) in the setting of acute respiratory distress syndrome (ARDS) is evolving and durations of support once considered extreme are now commonplace.... read more

Early Ketamine Sedation Outcomes Among Mechanically Ventilated COVID-19 Patients

In a diverse sample of U.S. hospitals, about one in 30 patients mechanically ventilated with COVID-19 received ketamine infusions. Early ketamine may have an association with higher hospital mortality, increased total cost,... read more