Critical Care General
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Strike the Balance: Evolving Venous Access Practices in the Intensive Care Unit
This feature offers a focused review of the existing literature on PICC and temporary CVC use in the critically ill for healthcare professionals navigating this rapidly evolving field during their daily clinical activities.
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Lung Ultrasound Score Can Adequately Diagnose Acute Respiratory Distress Syndrome
In this prospective, observational study, lung ultrasound showed comparable diagnostic performance to standard diagnostics but better accuracy.
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Studying Patients at High Risk for Death in the ICU Can Give Them a Voice and Help Clinicians Understand Their Concerns
Using a multiple-source approach, this study showed that when given a voice, patients at high risk of dying in the intensive care unit express variable logistical, spiritual, physical, psychological, and existential concerns that clinicians should consider and address.
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Diagnosis and Management of Pulmonary Embolism in the ICU
Prompt diagnosis and management of pulmonary embolism in the emergency room and intensive care unit (ICU), therefore, may affect the course of these patients.
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Intravenous vs. Nebulized Tranexamic Acid and Hemoptysis: Which Strategy Is Better?
A pragmatic, open-label, randomized, parallel, single-center pilot trial investigating nebulized vs. intravenous tranexamic acid in patients with non-massive hemoptysis showed that nebulized tranexamic acid may be more effective in reducing the amount of hemoptysis and the need for interventional procedures.
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Midline Catheters May Be a Safe Alternative to PICCS for Vasopressor Infusion
In this study evaluating safety outcomes of infusing vasopressors through a midline catheter, there was no increase in catheter-related complications when comparing administration of vasopressors through a midline to administration through a peripherally inserted central catheter (PICC) or when compared to midline use with vasopressor infusion via a different catheter. There was an overall greater risk of systemic thromboembolism when midlines were used for vasopressor administration vs. PICCs or midlines with vasopressors administered through a different catheter.
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Re-Evaluation of Dosing for Venous Thromboembolism Prophylaxis
Prevention of venous thromboembolism (VTE) is important for all hospitalized patients to prevent additional morbidity and costs during hospitalization. Critically ill patients in the intensive care unit (ICU) may have additional risk factors that predispose them to VTE.
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Simple Aspiration for First-Episode Primary and Complete Pneumothorax
The investigators found a higher rate of failure with simple aspiration as a first-line intervention for primary spontaneous pneumothorax compared to chest tube drainage, but it was better tolerated with fewer adverse events.
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Benefits of Prophylactic Platelet Transfusion Before Central Venous Line Placement May Outweigh Risks in Patients with Severe Thrombocytopenia
In this multicenter, randomized, controlled, noninferiority trial of patients with severe thrombocytopenia, prophylactic platelet transfusion prior to central venous catheter (CVC) placement resulted in less CVC-related bleeding.
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Emerging Treatment for Refractory Vasodilatory Shock
Shock is a common cause for intensive care unit admission, necessitating rapid treatment of the underlying cause while supporting patients with fluids and vasopressor agents. Typical vasopressor agents include adrenergic agonists and vasopressin. When shock persists despite these interventions, this is labeled refractory shock.