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In patients with acute lung injury or ARDS, the addition of higher PEEP levels to the strategy of a low tidal volume does not improve clinical outcomes.
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There currently exists much evidence to direct the application of Noninvasive Positive Pressure Ventilation (NPPV). NPPV for the treatment of patients with acute respiratory failure has generated several meta-analyses and systematic reviews,1-4 including a recent one by Dean R. Hess PhD, RRT.
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This second and final part of a series covers the topics of differential diagnosis that must be considered when a patient presents with symptoms consistent with PE, treatment, and considerations for prevention of this disease state.
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Optimizing outcomes in patients with acute coronary syndrome requires matching patients with strategies that will produce the best results in specific clinical subgroups. Identifying those patients with ST elevation myocardial infarction (STEMI) who represent ideal candidates for fibrinolysis, and who are likely to have outcomes that are at least as favorable as they would have with percutaneous interventions, has become an area of intense focus among cardiologists and emergency physicians. Significant improvements in patient outcomes will be made when patients are managed according to their institutional capabilities, with the understanding that prompt thrombolysis in the setting of STEMI is fundamental to optimal patient care. This article, the second in a two-part series, provides a practical, evidence-based approach to comprehensive management of this patient population.
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In patients with ALI/ARDS from pulmonary and extrapulmonary causes, receiving mechanical ventilation with low tidal volumes and high PEEP, short-term effects of recruitment maneuvers as conducted in this study are variable.