Critical Care Alert
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High Pleural Pressure Prevents Overdistension in ARDS Patients with High Body Mass Index
High airway pressure is required to recruit lung atelectasis in patients with acute respiratory distress syndrome and body mass index ≥ 35 kg/m2. -
Use Push-Dose Phenylephrine with Caution in Septic Patients
Phenylephrine pushes in septic patients were associated with early hemodynamic stability, but higher intensive care unit mortality.
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The Effect of Antiviral Drugs on COVID-19 Outcomes and Mortality
The WHO Solidarity Trial Consortium found that remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had “little or no effect” on relevant outcomes. -
Prone Positioning May Improve Outcomes for Patients on ECMO for Severe ARDS
In patients on venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome, prone positioning is safe and feasible. Prone positioning appears to improve survival but increases length of stay. -
Ethics in the ICU: Negotiating Requests for Inappropriate Treatments
When requests for potentially inappropriate treatments occur, the initial steps include increasing communication and improving mutual understanding to find a path that is appropriate while honoring the goals and concerns expressed by patients and their families. -
Rapid Intermittent Bolus of Hypertonic Saline May Be a Better Way to Correct Symptomatic Hyponatremia
In this randomized clinical trial, hypertonic saline given via rapid intermittent bolus therapy was as effective and safe as slow continuous infusion, and was associated with a lower rate of recorrecting treatment and higher efficacy in achieving goal sodium within one hour.
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Using Procalcitonin to Limit Antibiotic Treatment for Sepsis Reduces Infection-Related Adverse Events
By shortening the duration of antibiotic therapy, a procalcitonin-guided protocol decreased the rate of infection-associated adverse effects, decreased costs, and reduced mortality in patient with sepsis.
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Post-COVID-19: The Crisis After the Crisis
Critical care physicians have the opportunity to optimize long-term function and quality of life for COVID-19 survivors. It is paramount to prevent, recognize, and treat post-COVID-19 symptoms.
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Defining Patient- and Family-Centered Care Outcomes in the ICU
Using semi-structured interviews with intensive care unit (ICU) survivors and their family members, investigators identified several ICU processes of care and outcomes after the ICU that were important to this population.
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COVID-19 ARDS Is Associated with Higher Compliance and Lung Gas Volume Compared to Non-COVID-19 ARDS
This retrospective analysis compared historical cohorts with COVID-19-related acute respiratory distress syndrome (ARDS) with respect to compliance and arterial partial pressure of oxygen/fraction of inspired oxygen (P/F) ratios. For comparable P/F ratios, patients with ARDS caused by COVID-19 had higher lung compliance and more lung gas volume.