Tag: therapy
Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in ICU patients with infection and sepsis patients
Procalcitonin-guided antibiotic treatment in ICU patients with infection and sepsis patients results in improved survival and lower antibiotic treatment duration. Mortality in the 2252 procalcitonin-guided patients was significantly... read more
Hemodynamic Consequences of Severe Lactic Acidosis in Shock States
Deleterious hemodynamic effects of severe lactic acidosis are largely suggested by experimental data, although not fully confirmed by human studies. Pending the effectiveness of an etiological treatment, there is no efficient... read more
Legacy Emanuel Medical Center Plants With Purpose
The benefits of access to nature have been shown in a variety of settings and contexts, notes Roger S. Ulrich, an international leader in evidence-based healthcare design and a consultant to Legacy Health’s therapeutic... read more
Cryptococcus Neoformans Meningoencephalitis
A 36-year-old man presented to the emergency department with a 2-week history of fever, headache, drowsiness, and photophobia. He was previously healthy and was sexually active with men. The physical examination was notable... read more
Vascular Effects of Adrenomedullin and the Anti-Adrenomedullin Antibody Adrecizumab in Sepsis
Sepsis remains a major scientific and medical challenge, for which, apart from significant refinements in supportive therapy, treatment has barely changed over the last few decades. During sepsis, both vascular tone and vascular... read more
Choice of Fluid Therapy in the Initial Management of Sepsis, Severe Sepsis, and Septic Shock
Sepsis results in disruption of the endothelial glycocalyx layer and damage to the microvasculature, resulting in interstitial accumulation of fluid and subsequently edema. Fluid resuscitation is a mainstay in the initial... read more
Medications and RRT: We Know How to Dose, Right?
Dr. Fraser, MD, speaks with Bruce A. Mueller, PharmD, FCCP, FASN, about his talk presented at the 47th Critical Care Congress in San Antonio, Texas, entitled "Artificial Kidney Meets Mechanical Lung: Comanaging the Patient... read more
Sodium Bicarbonate Therapy for Patients with Severe Metabolic Acidaemia in the ICU
In patients with severe metabolic acidaemia, sodium bicarbonate had no effect on the primary composite outcome. However, sodium bicarbonate decreased the primary composite outcome and day 28 mortality in the a-priori defined... read more
Treatment of Acute Non-Anion Gap Metabolic Acidosis
Acute non-anion gap metabolic acidosis is now recognized to be as a common cause of metabolic acidosis, particularly in the ICU. Further examination of its impact on cellular function and clinical outcome are needed. Most... read more
Warfarin Nonadherence: What Factors Lead Patients with Afib to Discontinue?
Patients with atrial fibrillation (AF) frequently discontinue their warfarin therapy, and a recently-published study offers insight into factors that may contribute to nonadherence. The report, released in JAMA Cardiology,... read more
The 11th Pitfall: Thiamine Deficiency
Thiamine deficiency may occur in critically ill patients in case of increased glucose metabolism (i.e., in septic states or post-surgical phases), sudden or aggressive nutrition delivery to malnourished patients (refeeding... read more
Utility of Adjunct Antibiotics After I+D – Systematic Review + Meta-Analysis
Skin and soft tissue abscesses are a common emergency department (ED) presentation. The approach to management has changed little in recent decades: incision and drainage (I+D) and then discharge home with follow up. However,... read more
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 stratification,... read more
The Efficacy of ECMO for Severe ARDS
The H1N1 epidemic demonstrated that extracorporeal membrane oxygenation (ECMO) use in the most critically ill patients with acute respiratory distress syndrome (ARDS) resulted in a substantial decrease in mortality. The CESAR... read more
FIRST-line Support for Assistance in Breathing in Children (FIRST-ABC)
A multicentre pilot randomised controlled trial of high-flow nasal cannula therapy versus continuous positive airway pressure in pediatric critical care. Our pilot trial confirms that, following minor changes to consent procedures... read more
The Role of Speech and Language Therapy in Critical Care
The role of speech and language therapists (SLTs) in critical care can be unclear so this article sets out the scope of practice to increase awareness of the value of SLTs as part of the wider multidisciplinary team. Speech... read more
Looking for a Better Way to Treat Hypoxia in the Emergency Department? Reach for High-Flow Nasal Cannula
High-flow nasal cannula should be considered a first-line therapy in all patients with hypoxemic respiratory failure not from cardiogenic pulmonary edema and without concomitant hypercapnia. The high flow rate of HFNC offers... read more
Comparison of Transplant Waitlist Outcomes for Pediatric Candidates Supported by Ventricular Assist Devices Versus Medical Therapy
This is a comparative study of ventricular assist devices versus medical therapy in children. Age is a significant modulator of waitlist outcomes for children with end-stage heart failure supported by ventricular assist device,... read more
Cystic Fibrosis Transmembrane Conductance Regulator Potentiation as a Therapeutic Strategy for Pulmonary Edema
Cystic fibrosis transmembrane conductance regulator potentiation by ivacaftor is a novel therapeutic approach for pulmonary edema. Ivacaftor significantly improved alveolar liquid clearance in isolated pig lung lobes ex vivo... read more
The Use of Bolus-Dose Vasopressors in the Emergency Department
While bolus-dose vasopressors are commonly used in critical care medicine and anesthesiology to treat patients with hypoperfusion, its application in emergency medicine is minimal with little penetration into daily care.... read more
Comparing Effects Between Music Intervention and Aromatherapy on Anxiety of Patients Undergoing Mechanical Ventilation in the ICU
Music and aromatherapy interventions were both effective for ICU patients. The effects of music intervention were greater than that of aromatherapy; both interventions maintained the effects for at least 30 min. The Music... read more
Empiric Antibiotics Tend To Be Prolonged in ICU
Using antibiotics in critically ill patients is very much walking a tightrope. No one wants to miss an infection in a patient who could go downhill quickly, but no one wants to overuse these precious drugs, either.... read more
