Critical Care Topics
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American Heart Association Urges Improvement in Stroke Care
In a scientific statement, the group offered tactics to eliminate the racial and ethnic inequities that exist in stroke incidence, prevalence, treatment, and outcomes.
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Do Race and Ethnicity Affect the Likelihood of ICU Admission?
Patients who identify with racial or ethnic minority groups and present with sepsis or acute respiratory failure are more likely to be admitted to the ICU when compared to white patients.
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Steroids and Pneumonia — So Meta?
In a multicenter, randomized, placebo-controlled trial, hydrocortisone reduced mortality in patients with severe community-acquired pneumonia.
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Adjuvant Systemic Corticosteroid Therapy in Hospitalized Patients with Community-Acquired Pneumonia
This systematic review and meta-analysis of 16 randomized controlled trials (RCTs) studied the use of adjunctive corticosteroid therapy in community-acquired pneumonia. All-cause mortality, intensive care unit admission, and incidence of adverse events were similar in patients who received corticosteroids compared to standard care. However, the corticosteroid therapy group had a lower incidence of progression to mechanical ventilation.
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New Ethical Guidance on End-of-Life Nutrition Therapy
The guidance is intended to help clinicians understand what medically assisted nutrition and hydration can and cannot accomplish for different groups of patients.
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Ethicists Can Resolve Conflicts Over Nutrition Therapy at End of Life
When deciding whether to administer, withhold, or withdraw end-of-life nutrition and hydration therapy, ethicists can help clinicians, patients, and families reach an equitable agreement.
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Ethicists’ Role if Clinicians Disregard Documented End-of-Life Wishes
Early involvement of the ethics team can be helpful. After an initial assessment, the healthcare team should arrange a family meeting with surrogates, clinicians, the ethics team, social workers, and other appropriate individuals (e.g., clergy). This should happen as soon as possible, no later than the following day. The ethics team should facilitate an honest and compassionate discussion about the plan to best honor the patient’s end-of-life decisions.
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Wrongful Prolongation of Life Suits Persist, Even When a Patient’s Status Was DNR
Regardless of training or good intentions to preserve life, at the end of the day, this is the patient's choice.
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Florida Hospital Tests Safety Bundle to Improve Alarm Management
With better communication and training, staff on a surgical ICU improved their responses to emergency alarms and alleviated alert fatigue.
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Antibacterial Therapy in the Critically Ill
Appropriate antibiotic therapy in the critically ill requires consideration of important patient-specific factors, such as antibiotic therapy in the preceding 30 days; culture and sensitivity data, if available, within the prior six months; and local resistance patterns.