Ventilators
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Ethicists Debate Withdrawing ECMO Over Patient’s Objections
The commonly used ethical justifications for unilateral withdrawal over the objection of a patient with decision-making capacity are problematic. The ethicists’ task is to help stakeholders examine the underlying assumptions in light of the available empirical evidence or potential counterarguments.
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Practice Alert Provides Critical Care Nurses Safety Tips for Prone Positioning
The technique that became well known during the COVID-19 pandemic remains a standard tactic for managing acute respiratory distress syndrome.
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Limitation of Tidal Volume Is Cardioprotective Among Mechanically Ventilated Patients Undergoing Cardiac Surgery
In this experimental study, rising tidal volume increased right ventricular afterload.
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Appropriate Oxygenation Targets in the Treatment of Hypoxemic Respiratory Failure
The care of critically ill patients in the ICU remains challenging. Recent studies support current protocols for the delivery of oxygen to patients who require supplemental oxygen due to respiratory failure of varying etiologies. Broad oxygenation targets of SpO2 between 88% to 97% continue to be supported by recent trials.
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Patients’ Goals During Long-Term Acute Care Hospital Stays
After a long-term acute care hospital stay, most patients will achieve goals of ventilator liberation, eating, drinking, and speaking, but many will not achieve independence in walking, grooming, toileting, or returning home.
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Study: More Than Half of DNR ED Patients Resuscitated Against Their Wishes
Of 419 cardiac arrest patients, 65 were DNR status. Of this group of DNR patients, 38 were resuscitated against their wishes. Not adhering to a patient’s wishes not only violates their autonomy, but it is arguably not acting in the patient’s best interest — and may in fact be causing them harm.
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Routine Ethics Consults Helpful if ECMO Is Considered
When a patient is placed on extracorporeal membrane oxygenation (ECMO), usually emergently, families have begun to face the gravity of the situation. Suddenly, ECMO offers new hope. Even though the primary team explains ECMO will be a time-limited trial and a bridge to recovery, transplant, or device, many families remain focused only on the possibility of hope.
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Court Ruling on Life Support Withdrawal Affects Ethics Committees
Hospitals may need to afford more procedural due process when deciding on whether to withhold or withdraw life-sustaining treatment without consent.
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Do Not Intubate Orders Becoming More Common
Rates increased over time, from about one in 10 patients 20 years ago to about one in three patients in the past five years. The exact reasons for this increase remain unclear.
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Early Data on Remdesivir for Severe COVID-19: A Promising Start?
In this group of patients hospitalized with severe COVID-19, most of whom required invasive ventilation, 68% showed clinical improvement after treatment with remdesivir on a compassionate-use basis.