Critical Care
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Individualized Oxygen Targets May Improve Outcomes in Mechanically Ventilated Patients
Using a machine learning algorithm, a predictive model demonstrated that different oxygen targets for mechanically ventilated patients may improve outcomes.
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Racial Inequities in Shared Decision-Making for Critically Ill Patients
In this thematic analysis of a previously conducted randomized clinical trial, disparate shared decision-making behaviors were observed among meetings with white vs. Black caregivers of critically ill patients, illustrating opportunities for future clinician-level interventions.
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Health Disparities and Inequities in the Intensive Care Unit and Beyond
Disparities and inequity are everywhere, including in the ICU. This article will review some of the disparities that are present in the ICU, provide a reflection on possible root causes, and identify ideas to combat these inequities.
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Increased Risk of Morbidity with Prolonged Use of Proton Pump Inhibitors Without an Indication Post-ICU
In previously critically ill adults, the use of a proton pump inhibitor without an indication for more than eight weeks increased morbidity and mortality.
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Another Step in the Journey to Combat Diagnostic Errors in Hospitalized Patients
Diagnostic errors in hospitalized patients who died or were transferred to the intensive care unit were common in this large retrospective, multicenter trial and frequently associated with patient harm. Problems with clinical assessment and ordering and interpreting tests were the most prevalent diagnostic process faults, with sepsis the diagnosis most associated with diagnostic error.
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Corticosteroids as Adjuvant Therapy for Community-Acquired Pneumonia
This article aims to provide a summative analysis of the existing medical literature surrounding the effect of steroid treatment on community acquired pneumonia, including recent updates.
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Withholding Intubation in Select Comatose Patients with Acute Poisoning May Be Beneficial
In this unblinded, randomized trial of adults presenting with acute poisoning and a Glasgow Coma Scale score less than 9, those for whom intubation was withheld unless emergently indicated had decreased intensive care unit and hospital lengths of stay and a lower rate of pneumonia.
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Low-Dose vs. Conventional-Dose TMP-SMX to Treat Pneumocystis Pneumonia in Non-HIV Patients
In patients without human immunodeficiency virus who were diagnosed with Pneumocystis jirovecii pneumonia, mortality rates were similar between the low-dose vs. conventional-dose trimethoprim-sulfamethoxazole (TMP-SMX) groups, while low-dose TMP-SMX was associated with fewer adverse events.
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High-Flow Nasal Oxygen for Acute Hypoxemic Respiratory Failure Due to COVID-19 Is Safe Initiated Outside the ICU
This study of hospitalized adults with COVID-19-related hypoxemic respiratory failure found that initiation of high-flow nasal oxygen on the wards was safe, resulted in comparable intubation and mortality rates, and led to less time in the intensive care unit.
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Norepinephrine Can Be Infused Safely Via Peripheral IV Catheter
Peripheral administration of norepinephrine has a low risk of extravasation if following an operationalized protocol.