Ventilatory Support and Mechanical Properties of the Fibrotic Lung Acting as a “Squishy Ball”

Ventilatory Support and Mechanical Properties of the Fibrotic Lung Acting as a “Squishy Ball”

The management of the patient with lung fibrosis in the ICU is a challenge for the intensivist. The lack of studies defining the mechanical ventilation strategy, and the different underlying etiologies, make it difficult... read more

TAPSE Has Superior Predictive Value vs. RV/LV Ratio in Normotensive Patients with Acute Pulmonary Embolism

TAPSE Has Superior Predictive Value vs. RV/LV Ratio in Normotensive Patients with Acute Pulmonary Embolism

Right ventricular dysfunction (RVD) is an indicator of poor prognosis in normotensive patients with acute pulmonary embolism (APE). The aim of this study was to compare right ventricular (RV)/left ventricular (LV) ratio measured... read more

Applied Physiology at the Bedside: Volumetric Capnography

Applied Physiology at the Bedside: Volumetric Capnography

Volumetric capnography is the graphical representation of the partial pressure of carbon dioxide (CO2) versus exhaled volume. This measurement is made noninvasively at every breath by a combination of flow and CO2 sensors,... read more

Catheter Type in Pulmonary Embolism Intervention

Catheter Type in Pulmonary Embolism Intervention

Catheter based interventions for pulmonary embolism is on the rise. The rise in mainly in patients who present with submassive PE. The intent of intervention is to reduce clot burden. This is done to improve acute symptoms... read more

Mimics of Sepsis: What do ED Physicians Need to Know?

Mimics of Sepsis: What do ED Physicians Need to Know?

SIRS and sepsis are common clinical entities. A wide range of estimates for prevalence exists, with 300 to 1000 cases per 100,000 persons per year. Once a septic patient is admitted, more than half will require at least step... read more

Subsegmental Pulmonary Embolism: Anticoagulation or Observation?

Subsegmental Pulmonary Embolism: Anticoagulation or Observation?

As the use of chest CT-angiograms in emergency departments and medical wards has risen by more than tenfold, so has the discovery of small pulmonary emboli of unclear clinical significance. These PEs are often isolated to... read more

Common pitfalls in point-of-care ultrasound: a practical guide for emergency and critical care physicians

Common pitfalls in point-of-care ultrasound: a practical guide for emergency and critical care physicians

Point-of-care ultrasonography (POCUS) is a widely used tool in emergency and critical care settings, useful in the decision-making process as well as in interventional guidance. Following some rules in technique and interpretation,... read more

What’s New in Severe Pulmonary Embolism?

What’s New in Severe Pulmonary Embolism?

Severe pulmonary embolism (PE) remains a major cause of mortality. For intensivists managing the most "severe" forms of PE, we highlight the main recent advances in the care of such patients including risk stratiļ¬cation,... read more

The Speed of Sound: A New Measure to Single Out High-Risk PE Patients

The Speed of Sound: A New Measure to Single Out High-Risk PE Patients

Predicting which pulmonary embolism patients will do well with oral anticoagulation and which will decompensate is a bit murky, at best. The treatment of pulmonary embolism (PE) has evolved quite a bit in just the past few... read more

Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients

Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients

Does use of the pulmonary embolism rule-out criteria (PERC) in emergency department patients with low clinical probability of pulmonary embolism (PE) safely exclude the diagnosis of PE? Among very low-risk patients with suspected... read more

Prevalence of Pulmonary Embolism in Patients With Syncope

Prevalence of Pulmonary Embolism in Patients With Syncope

The results of the present study confirm that pulmonary embolism (PE) is rarely identified in patients presenting to the ED with syncope. Although PE should be considered as a differential diagnosis in every patient, not... read more

Risk of Venous Thromboembolism in Patients by Albuminuria and Estimated GFR

Risk of Venous Thromboembolism in Patients by Albuminuria and Estimated GFR

Albuminuria increases the risk for VTE markedly in patients with normal eGFRs compared with those with lower eGFRs. 15,180 (2.2%) VTE events occurred during the study period. Both albuminuria and eGFR were independently associated... read more

Diagnostic Accuracy of Point-of-Care Ultrasound Performed by Pulmonary Critical Care Physicians for Right Ventricle Assessment in Patients With Acute Pulmonary Embolism

Diagnostic Accuracy of Point-of-Care Ultrasound Performed by Pulmonary Critical Care Physicians for Right Ventricle Assessment in Patients With Acute Pulmonary Embolism

This is the first study to evaluate pulmonary critical care fellows' and intensivists' use of goal-directed echocardiography in diagnosing right ventricular dysfunction in acute pulmonary embolism. Pulmonary Critical Care... read more

The YEARS Study – Simplified Diagnostic Management of PE

The YEARS Study – Simplified Diagnostic Management of PE

The clinical diagnosis of pulmonary embolism (PE) can be challenging given its variable presentation, requiring dependence on objective testing. Decision instruments such as PERC and the Wells' score help stratify patients... read more

Frequency of pulmonary embolism amongst patients admitted for first-time syncope

Frequency of pulmonary embolism amongst patients admitted for first-time syncope

All patients admitted to an inpatient service for first-time syncope from the emergency departments of 11 Italian hospitals from 2012-2014 were evaluated for pulmonary embolism. Pulmonary embolism was found in 17.3% of patients... read more

FDA approves betrixaban for VTE prophylaxis

FDA approves betrixaban for VTE prophylaxis

Betrixaban, a factor Xa inhibitor, has been approved for the prophylaxis of venous thromboembolism (VTE) in at-risk adult patients hospitalized with an acute illness, according to an announcement from the Food and Drug Administration.... read more

MRI in Pulmonary Embolism Diagnosis

MRI in Pulmonary Embolism Diagnosis

Magnetic resonance imaging (MRI) has high specificity but limited sensitivity for the diagnosis of pulmonary embolism (PE), according to a systematic review published in the journal Thrombosis Research. Given these inconclusive... read more