Tag: treatment
Pediatric Hypertension and Hypertensive Emergencies: Recognition and Management in the Emergency Department
Pediatric hypertension generally presents to the ED in 2 forms: (1) the otherwise asymptomatic child with elevated blood pressure, and (2) the child with a true hypertensive emergency. This issue provides recommendations... read more
Cost-effectiveness analysis of initial treatment strategies for mild-to-moderate Clostridium difficile infection in hospitalized patients
A decision-analytic model revealed vancomycin to be cost-effective, compared with metronidazole, for treatment of initial episodes of mild-to-moderate Clostridium difficile infection (CDI) in adult inpatients. From the hospital... read more
Antibiotics, Immunosuppressive Drugs and the Downfall of the Human Immune System
Today I'll discuss two more factors that can debilitate the human immune system (allowing the microbiome to better cause disease). They are antibiotics (when used too frequently) and immunosuppressive drugs: two of the most... read more
Addressing Shortcomings in Infection and Sepsis Treatment Should Be Top of the Priority List
Hospitals are increasingly facing the challenge of cutting costs while also improving clinical outcomes. This is certainly true in the infectious disease sector, as unrecognized or ineffectively treated bacterial infections... read more
Is Pre-hospital Coagulation Management in Trauma Feasible?
Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase. The burden of trauma is... read more
Regeneration of Severely Damaged Lungs Using an Interventional Cross-circulation Platform
The number of available donor organs limits lung transplantation, the only lifesaving therapy for the increasing population of patients with end-stage lung disease. A prevalent etiology of injury that renders lungs unacceptable... read more
How can we make ICU rehabilitation easier for patients and relatives?
Zoe van Willigen is a Physiotherapist in Critical Care at University Hospital Southampton NHS Foundation Trust. Her study aims to explore patients' and relatives' experiences of ICU rehabilitation (being mobilised out of... read more
Sedation Practice in ECMO-Treated Patients with ARDS
Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective... read more
Metabolic Acidosis: A Guide to Clinical Assessment and Management
This timely volume provides an overview to the causes, effects on systems and clinical approaches of metabolic acidosis. Beginning with a basic understanding of the physiology, pathophysiology and development of this disease,... read more
Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again
Medicine has become inhuman, to disastrous effect. The doctor-patient relationship--the heart of medicine--is broken: doctors are too distracted and overwhelmed to truly connect with their patients, and medical errors and... read more
Reducing Emergency Department Length of Stay
An interdisciplinary team of front-line physicians, nurses, medical assistants, and executives assembled and used value stream mapping to assess the entire ED care process, from patient arrival to admission or discharge.... read more
Immunotherapy Effects on Sepsis
A randomised controlled multicentre trial assessed for the first time the safety and pharmacokinetics of an antiprogrammed cell death-ligand 1 (anti–PD-L1) immune checkpoint inhibitor (BMS-936559; Bristol-Myers Squibb,... read more
Lactate-Guided Resuscitation Only Encourages Over-Resuscitation and Downstream Harms
The Centers for Medicare and Medicaid Services and the Surviving Sepsis Campaign both rushed to offer guidance on the appropriate management strategies for patients presenting with septic shock. In both cases, a lactate-guided... read more
Prognostic Accuracy of the Serum Lactate Level, the SOFA Score and the qSOFA Score for Mortality Among Adults with Sepsis
Sepsis is a common critical condition caused by the body’s overwhelming response to certain infective agents. Many biomarkers, including the serum lactate level, have been used for sepsis diagnosis and guiding treatment.... read more
High-flow Oxygen Through Nasal Cannula in Acute Hypoxemic Respiratory Failure
In patients with nonhypercapnic acute hypoxemic respiratory failure, treatment with high-flow oxygen, standard oxygen, or noninvasive ventilation did not result in significantly different intubation rates. There was a significant... read more
Optimizing Ceftolozane-tazobactam Dosage in Critically Ill Patients During Continuous Venovenous Hemodiafiltration
Ceftolozane-tazobactam (C/T), the combination of a new cephalosporin with a classic β-lactamase inhibitor, is currently considered the most active betalactam antibiotic against P. aeruginosa. Despite several case reports... read more
In-Hospital Cardiac Arrest
In-hospital cardiac arrest is common and associated with a high mortality rate. Despite this, in-hospital cardiac arrest has received little attention compared with other high-risk cardiovascular conditions, such as stroke,... read more
Why Most Diagnostic Procedures Aren’t Beneficial
We often assume that diagnostic procedures will help patients. A lot of training goes into learning how to do these procedures. Procedures are dramatic. We like performing them. Patients are impressed, perceiving that we... read more
Loss of Sphingosine 1-Phosphate in Septic Shock is Predominantly Caused by Decreased Levels of HDL
Sphingosine 1-phosphate (S1P) is a signaling lipid essential in regulating processes involved in sepsis pathophysiology, including endothelial permeability and vascular tone. Serum S1P is progressively reduced in sepsis patients... read more
Optimizing Beta-Lactam Treatment in the ICU
The French Society of Pharmacology and Therapeutics (SFPT) and the French Society of Anesthesia and Intensive Care Medicine (SFAR) have released guidelines on the optimization of beta-lactam treatment in intensive care unit... read more
Neutrophil Extracellular Traps Are Elevated in Patients with Pneumonia-related ARDS
Bronchoalveolar neutrophil extracellular trap concentration was not significantly associated with mechanical ventilation duration in pneumonia-related ARDS. The acute respiratory distress syndrome (ARDS) is the most severe... read more
Research Ethics and Informed Consent in Critical Care
Research studies in critically ill populations pose many unique regulatory and ethical challenges that have implications for study design and execution. The life-threatening nature of conditions being studied and the urgency... read more
