Critical Care Topics
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Vitamin C, Thiamine, and Hydrocortisone for Septic Shock
The combination of vitamin C, thiamine, and hydrocortisone did not improve outcomes compared with hydrocortisone alone in patients with septic shock.
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Pressure Support vs. T-Piece Trials for Successful Extubation: An End to the Controversy?
In a randomized clinical trial of 1,153 adults who were ready for weaning after at least 24 hours of mechanical ventilation, researchers found that a spontaneous breathing trial with 30 minutes of pressure support ventilation compared with two hours of T-piece ventilation led to significantly higher successful extubation rates.
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Critical Care in the Obese Patient
This article will highlight some important practical aspects of care that arise in the management of critically ill obese patients, along with the unique physiology resulting from obesity.
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Laryngeal Injury Is Common After 12 Hours of Intubation
After 12 hours of intubation, most patients showed laryngeal injury, including mucosal ulceration, that led to impaired breathing and voicing 10 weeks after extubation.
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Management of Nontraumatic Intracranial Emergencies: A Clinical Update
This article attempts to provide evidence-based, practical guidelines to the frontline clinician in the nontrauma intensive care setting.
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Efficacy of Vitamin C Infusion on Outcomes in Sepsis-Induced ARDS
In this randomized, double-blinded, placebo-controlled trial, intravenous vitamin C infusion did not influence a change in the modified Sequential Organ Failure Assessment score from the time of infusion to four days compared to placebo.
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Longer Antibiotic Courses for Pneumonia Do Not Improve Outcomes, But Cause More Adverse Effects
Two-thirds of general medicine patients with pneumonia received excess antibiotic therapy, with 93.2% of the unnecessary duration occurring after hospital discharge. Excess antibiotic therapy did not improve mortality or morbidity outcomes, although each additional antibiotic day was associated with 3% increased odds of antibiotic-associated adverse drug events.
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Antimicrobial Stewardship in Critical Care
Antimicrobial stewardship is the responsibility of everyone involved in the care of critically ill and hospitalized patients. This review discusses some of the key principles and practices of successful antimicrobial stewardship programs, particularly as they relate to critical care.
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Seven Days of Antibiotics Was Noninferior to 14 Days for Gram-Negative Rod Bacteremia
In patients with gram-negative rod bacteremia, patients receiving seven days of antibiotics had similar 90-day mortality, readmission rates, and rates of recurrent bacteremia as patients receiving 14 days of antibiotic.
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Balanced Crystalloids Reduce Mortality in Critically Ill Adults With Sepsis or Septic Shock
Compared to saline, balanced crystalloids reduced in-hospital mortality and major adverse kidney events within 30 days in critically ill patients with sepsis or septic shock.