Critical Care Topics
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The Epidemic of Vaping-Associated Lung Injury
Since June 2019, there has been a considerable rise in reported cases of vaping-associated lung injury.
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Early Dexmedetomidine Provides Similar 90-Day Mortality Compared to Usual Care in Mechanically Ventilated Critically Ill Adults
When the early use of continuous infusion dexmedetomidine was compared to usual care for sedation in mechanically ventilated critically ill adults, there was no difference in 90-day mortality. Dexmedetomidine may not be an ideal sedative for mechanically ventilated critically ill adults requiring deeper sedation, although its use may result in greater ventilator-free, coma-free, or delirium-free days.
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Acute Kidney Injury in Patients With Cirrhosis
Acute kidney injury and hepatorenal syndrome are common conditions found in patients with cirrhosis, due to the systemic vasodilation and systemic inflammation frequently found in this population.
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Temperature Trajectories to Find Sepsis Subphenotypes
The authors of this study used development and validation cohorts to retrospectively identify temperature trajectories over the first 72 hours from presentation in the setting of sepsis. Patients presenting with hyperthermia that resolved quickly (within the first 24 hours) had lower mortality compared to those with slow resolution or those presenting with hypothermia.
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Vasopressin Use in Septic Shock
Current management of septic shock includes early administration of intravenous fluids, antimicrobial agents, and vasopressor support. While norepinephrine is recommended as the first-line vasopressor for septic shock in the 2016 Surviving Sepsis Campaign guidelines, vasopressin is a second-line vasopressor option that may be added.
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Difficult Airway Intubation With Flexible Bronchoscope as a Guide
In this prospective study, use of a flexible bronchoscope as a flexible stylet and a Glidescope to provide visual guidance while intubating patients in the operating room was associated with shorter time to intubation than the use of Glidescope alone.
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Organ Donation: Perspective for the Intensivist
Organ donation and transplantation are important and lifesaving procedures.The complexities of management include determination of death, communication with families, pre-procurement optimization of potential donors, and bereavement support for families.
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Decision-Making Capacity in the ICU
A multicenter, one-day prevalence, prospective, observational, double-blind study in 19 ICUs revealed that the decisionmaking capacity of ICU patients was widely overestimated by all clinicians as compared with a capacity score measured by the Mini-Mental Status Examination and the Aid to Capacity Evaluation.
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Acute Kidney Injury With Combination Antibiotics in the Critically Ill
In this retrospective study, a short course (24 to < 72 hours) of combination antibiotic therapy with piperacillin-tazobactam and vancomycin was not associated with an increased risk of acute kidney injury among critically ill patients when compared with other β-lactam and vancomycin combinations.
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NOACs vs. Warfarin: What Are the Data in Patients With Traumatic Brain Injury and Intracranial Hemorrhage?
A three-year analysis of a prospectively maintained database with traumatic brain injury patients revealed that novel oral anticoagulant use is associated with increased risk of intracranial hemorrhage progression, neurosurgical intervention, and mortality.