Tag: treatment
Mechanical Ventilation/Ventricular Assist Devices, An Issue of Critical Care Clinics
This issue of Critical Care Clinics focuses on Mechanical Ventilation and Ventricular Assist Devices, with topics including: Targeted management approach to cardiogenic shock; Prevention and treatment of right heart failure... read more
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Should ICU clinicians follow patients after ICU discharge? No
Post-intensive care syndrome (PICS) describes new or worsening impairments of physical, cognitive or mental health resulting from an episode of critical illness and its treatment and lasting after discharge... read more
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Should ICU clinicians follow patients after ICU discharge? Yes
The trajectory of recovery from critical illness is often portrayed as a continuum. At one extremity lies an unstable patient dependent on life-sustaining treatments in the intensive care unit. At the... read more
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Do phenylephrine and epinephrine require central access?
Until recently I believed that prolonged vasopressor administration requires a central line, to avoid extravasation. I lumped together all vasopressors, treating them all as equal. I used the occurrence of an extravasation... read more
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Haloperidol Serum Concentrations in Critically Ill Patients Included in the REDUCE Study
ICU delirium occurs frequently and is associated with unfavorable outcome. A recent delirium prevention study, the REDUCE study, has assessed the efficacy of prophylactic use of haloperidol. In this subset... read more
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Six Reasons to Avoid Fluoroquinolones in the Critically Ill
As an internal medicine resident and pulmonary/critical care fellow, I loved fluoroquinolones. They were effective, easy to prescribe, and had 100% oral bioavailability. However, working full-time in the ICU has forced me... read more
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Viral Sepsis in Children
Sepsis in children is typically presumed to be bacterial in origin until proven otherwise, but frequently bacterial cultures ultimately return negative. Although the incidence of viral-induced sepsis is not precisely known,... read more
Withdrawing vs. Not Offering Cardiopulmonary Resuscitation: Is There a Difference?
In light of the SCC's Cuthbertson v. Rasouli decision, the distinction between withdrawing and not offering a medical treatment is increasingly relevant. Because CPR is a "default" treatment for cardiac arrest, it requires... read more
High Flow Nasal Oxygen for Acute Bronchiolitis?
Since bronchiolitis is a clinical diagnosis, there is no test, including viral testing and radiography, which rules it in or out (Schuh et al 2007). Sadly, despite multiple guidelines (NICE, AAP, CPS), there has also been... read more
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The Needs of Families of Trauma Intensive Care Patients
This mixed methods study identified that families of trauma patients have different needs to families of general patients and the nurses rated the needs of the families of trauma patients as less important than the families... read more
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Hospitals Prepare To Launch Their Own Drug Company To Fight High Prices And Shortages
Shortages of commonplace generic drugs have plagued hospitals in recent years. And with short supplies and fewer suppliers for key drugs, there have been price increases. Hospital purchasing agents keep searching for new... read more
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Device Delivers Drugs to the Brain to Stop Seizures
The failure of systemic drug treatments to address numerous neurological disorders has spurred the development of alternative approaches that attempt localized treatment. These localized treatments focus therapy on the region... read more
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Lessons From Everest’s Sherpas Could Aid Intensive Care Treatment
A research expedition to Mount Everest has shed light on the unique physiological basis of adaptations seen in the native Sherpa people, which make them better suited to life at high altitude. This improved understanding,... read more
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Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions
From 2008 to 2015, total acute care utilization for the treatment of low-acuity conditions and associated spending per member in the United States increased, and utilization of non-ED acute care venues increased rapidly.... read more
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Time-limited Trial of Intensive Care Treatment
In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition,... read more
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New antibiotics and antimicrobial combination therapy for the treatment of gram-negative bacterial infections
Only few new molecules have an adequate activity against MDR gram-negative pathogens, especially carbapenemase-producer strains. Among these, ceftozolane/tazobactam has been recently approved for clinical use. Other compounds,... read more
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Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation
Among patients with severe secondary mitral regurgitation, the rate of death or unplanned hospitalization for heart failure at 1 year did not differ significantly between patients who underwent percutaneous mitral-valve repair... read more
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It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock
The administration of a continuous infusion of hydrocortisone to a general population of patients in septic shock on mechanical ventilation cannot be recommended at this time. The authors conclusion that glucocorticoids do... read more
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ECMO for Severe ARDS
Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every... read more
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Diagnosis and Treatment of Clostridium difficile Infection
Clostridium difficile infection (CDI) is less common than antibiotic-associated diarrhea and irritable bowel syndrome. There is significant concern about overdiagnosis and subsequent overtreatment of CDI with increasing use... read more
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Watchdog Group Calls for NIH to Halt Dangerous Study of Sepsis Treatment
A medical watchdog group is calling on the National Institutes of Health to immediately stop the enrollment of patients in a clinical trial of sepsis treatment and launch an investigation of how the study received approval,... read more