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https://www.readbyqxmd.com/read/27536694/fluid-management-for-critically-ill-patients-a-review-of-the-current-state-of-fluid-therapy-in-the-intensive-care-unit
#1
REVIEW
Erin Frazee, Kianoush Kashani
BACKGROUND: Intravenous fluids (IVF) are frequently utilized to restore intravascular volume in patients with distributive and hypovolemic shock. Although the benefits of the appropriate use of fluids in intensive care units (ICUs) and hospitals are well described, there is growing knowledge regarding the potential risks of volume overload and its impact on organ failure and mortality. To avoid volume overload and its associated complications, strategies to identify fluid responsiveness are developed and utilized more often among ICU patients...
June 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27670788/acute-kidney-injury-2016-diagnosis-and-diagnostic-workup
#2
Marlies Ostermann, Michael Joannidis
Acute kidney injury (AKI) is common and is associated with serious short- and long-term complications. Early diagnosis and identification of the underlying aetiology are essential to guide management. In this review, we outline the current definition of AKI and the potential pitfalls, and summarise the existing and future tools to investigate AKI in critically ill patients.
September 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27543137/echocardiography-in-shock-management
#3
REVIEW
Anthony S McLean
Echocardiography is pivotal in the diagnosis and management of the shocked patient. Important characteristics in the setting of shock are that it is non-invasive and can be rapidly applied.In the acute situation a basic study often yields immediate results allowing for the initiation of therapy, while a follow-up advanced study brings the advantage of further refining the diagnosis and providing an in-depth hemodynamic assessment. Competency in basic critical care echocardiography is now regarded as a mandatory part of critical care training with clear guidelines available...
August 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27418577/management-of-adults-with-hospital-acquired-and-ventilator-associated-pneumonia-2016-clinical-practice-guidelines-by-the-infectious-diseases-society-of-america-and-the-american-thoracic-society
#4
Andre C Kalil, Mark L Metersky, Michael Klompas, John Muscedere, Daniel A Sweeney, Lucy B Palmer, Lena M Napolitano, Naomi P O'Grady, John G Bartlett, Jordi Carratalà, Ali A El Solh, Santiago Ewig, Paul D Fey, Thomas M File, Marcos I Restrepo, Jason A Roberts, Grant W Waterer, Peggy Cruse, Shandra L Knight, Jan L Brozek
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia...
September 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27239312/neurocritical-care-update
#5
REVIEW
Yasuhiro Kuroda
This update comprises six important topics under neurocritical care that require reevaluation. For post-cardiac arrest brain injury, the evaluation of the injury and its corresponding therapy, including temperature modulation, is required. Analgosedation for target temperature management is an essential strategy to prevent shivering and minimizes endogenous stress induced by catecholamine surges. For severe traumatic brain injury, the diverse effects of therapeutic hypothermia depend on the complicated pathophysiology of the condition...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27161018/low-dose-versus-standard-dose-intravenous-alteplase-in-acute-ischemic-stroke
#6
RANDOMIZED CONTROLLED TRIAL
Craig S Anderson, Thompson Robinson, Richard I Lindley, Hisatomi Arima, Pablo M Lavados, Tsong-Hai Lee, Joseph P Broderick, Xiaoying Chen, Guofang Chen, Vijay K Sharma, Jong S Kim, Nguyen H Thang, Yongjun Cao, Mark W Parsons, Christopher Levi, Yining Huang, Verónica V Olavarría, Andrew M Demchuk, Philip M Bath, Geoffrey A Donnan, Sheila Martins, Octavio M Pontes-Neto, Federico Silva, Stefano Ricci, Christine Roffe, Jeyaraj Pandian, Laurent Billot, Mark Woodward, Qiang Li, Xia Wang, Jiguang Wang, John Chalmers
BACKGROUND: Thrombolytic therapy for acute ischemic stroke with a lower-than-standard dose of intravenous alteplase may improve recovery along with a reduced risk of intracerebral hemorrhage. METHODS: Using a 2-by-2 quasi-factorial open-label design, we randomly assigned 3310 patients who were eligible for thrombolytic therapy (median age, 67 years; 63% Asian) to low-dose intravenous alteplase (0.6 mg per kilogram of body weight) or the standard dose (0.9 mg per kilogram); patients underwent randomization within 4...
June 16, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27035241/routine-chest-radiography-is-not-necessary-after-ultrasound-guided-right-internal-jugular-vein-catheterization
#7
Justin J Hourmozdi, Abraham Markin, Brad Johnson, Patrick R Fleming, Joseph B Miller
OBJECTIVES: Central venous catheter placement is a common procedure performed on critically ill patients. Routine postprocedure chest radiographs are considered standard practice. We hypothesize that the rate of clinically relevant complications detected on chest radiographs following ultrasound-guided right internal jugular vein catheterization is exceedingly low. DESIGN: Retrospective chart review. SETTING: Adult ICUs, emergency departments, and general practice units at an academic tertiary care hospital system...
September 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26045965/mechanical-ventilation-of-acute-respiratory-distress-syndrome
#8
REVIEW
Ryoichi Ochiai
Acute respiratory distress syndrome (ARDS) has been intensively and continuously studied in various settings, but its mortality is still as high as 30-40 %. For the last 20 years, lung protective strategy has become a standard care for ARDS, but we still do not know the best way to ventilate patients with ARDS. Tidal volume itself does not seem to have an important role to develop ventilator-induced lung injury (VILI), but the driving pressure, which is inspiratory plateau pressure-PEEP, is the most important to predict and affect the outcome of ARDS, though there is no safe limit for the driving pressure...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/26976917/perioperative-management-to-reduce-cardiovascular-events
#9
REVIEW
Nathaniel R Smilowitz, Jeffrey S Berger
No abstract text is available yet for this article.
March 15, 2016: Circulation
https://www.readbyqxmd.com/read/26976648/bts-ics-guideline-for-the-ventilatory-management-of-acute-hypercapnic-respiratory-failure-in-adults
#10
A Craig Davidson, Stephen Banham, Mark Elliott, Daniel Kennedy, Colin Gelder, Alastair Glossop, Alistair Colin Church, Ben Creagh-Brown, James William Dodd, Tim Felton, Bernard Foëx, Leigh Mansfield, Lynn McDonnell, Robert Parker, Caroline Marie Patterson, Milind Sovani, Lynn Thomas
No abstract text is available yet for this article.
April 2016: Thorax
https://www.readbyqxmd.com/read/26780745/guidance-for-the-practical-management-of-the-heparin-anticoagulants-in-the-treatment-of-venous-thromboembolism
#11
REVIEW
Maureen A Smythe, Jennifer Priziola, Paul P Dobesh, Diane Wirth, Adam Cuker, Ann K Wittkowsky
Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing incidence. Despite the changing landscape of VTE treatment with the introduction of the new direct oral anticoagulants many uncertainties remain regarding the optimal use of traditional parenteral agents. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. This specific chapter addresses the practical management of heparins including low molecular weight heparins and fondaparinux...
January 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/21494105/real-time-ultrasound-guided-subclavian-vein-cannulation-versus-the-landmark-method-in-critical-care-patients-a-prospective-randomized-study
#12
RANDOMIZED CONTROLLED TRIAL
Mariantina Fragou, Andreas Gravvanis, Vasilios Dimitriou, Apostolos Papalois, Gregorios Kouraklis, Andreas Karabinis, Theodosios Saranteas, John Poularas, John Papanikolaou, Periklis Davlouros, Nicos Labropoulos, Dimitrios Karakitsos
OBJECTIVE: Subclavian vein catheterization may cause various complications. We compared the real-time ultrasound-guided subclavian vein cannulation vs. the landmark method in critical care patients. DESIGN: Prospective randomized study. SETTING: Medical intensive care unit of a tertiary medical center. PATIENTS: Four hundred sixty-three mechanically ventilated patients enrolled in a randomized controlled ISRCTN-registered trial (ISRCTN-61258470)...
July 2011: Critical Care Medicine
https://www.readbyqxmd.com/read/26903338/the-third-international-consensus-definitions-for-sepsis-and-septic-shock-sepsis-3
#13
Mervyn Singer, Clifford S Deutschman, Christopher Warren Seymour, Manu Shankar-Hari, Djillali Annane, Michael Bauer, Rinaldo Bellomo, Gordon R Bernard, Jean-Daniel Chiche, Craig M Coopersmith, Richard S Hotchkiss, Mitchell M Levy, John C Marshall, Greg S Martin, Steven M Opal, Gordon D Rubenfeld, Tom van der Poll, Jean-Louis Vincent, Derek C Angus
IMPORTANCE: Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination. OBJECTIVE: To evaluate and, as needed, update definitions for sepsis and septic shock. PROCESS: A task force (n = 19) with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine...
February 23, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26920728/the-abc-age-biomarkers-clinical-history-stroke-risk-score-a-biomarker-based-risk-score-for-predicting-stroke-in-atrial-fibrillation
#14
Ziad Hijazi, Johan Lindbäck, John H Alexander, Michael Hanna, Claes Held, Elaine M Hylek, Renato D Lopes, Jonas Oldgren, Agneta Siegbahn, Ralph A H Stewart, Harvey D White, Christopher B Granger, Lars Wallentin
AIMS: Atrial fibrillation (AF) is associated with an increased risk of stroke, which is currently estimated by clinical characteristics. The cardiac biomarkers N-terminal fragment B-type natriuretic peptide (NT-proBNP) and cardiac troponin high-sensitivity (cTn-hs) are independently associated with risk of stroke in AF. Our objective was to develop and validate a new biomarker-based risk score to improve prognostication of stroke in patients with AF. METHODS AND RESULTS: A new risk score was developed and internally validated in 14 701 patients with AF and biomarkers levels determined at baseline, median follow-up of 1...
May 21, 2016: European Heart Journal
https://www.readbyqxmd.com/read/26557478/recruitment-maneuvers-in-acute-respiratory-distress-syndrome-the-safe-way-is-the-best-way
#15
REVIEW
Raquel S Santos, Pedro L Silva, Paolo Pelosi, Patricia Rm Rocco
Acute respiratory distress syndrome (ARDS) represents a serious problem in critically ill patients and is associated with in-hospital mortality rates of 33%-52%. Recruitment maneuvers (RMs) are a simple, low-cost, feasible intervention that can be performed at the bedside in patients with ARDS. RMs are characterized by the application of airway pressure to increase transpulmonary pressure transiently. Once non-aerated lung units are reopened, improvements are observed in respiratory system mechanics, alveolar reaeration on computed tomography, and improvements in gas exchange (functional recruitment)...
November 4, 2015: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26759045/iron-management-in-chronic-kidney-disease-conclusions-from-a-kidney-disease-improving-global-outcomes-kdigo-controversies-conference
#16
Iain C Macdougall, Andreas J Bircher, Kai-Uwe Eckardt, Gregorio T Obrador, Carol A Pollock, Peter Stenvinkel, Dorine W Swinkels, Christoph Wanner, Günter Weiss, Glenn M Chertow
Before the introduction of erythropoiesis-stimulating agents (ESAs) in 1989, repeated transfusions given to patients with end-stage renal disease caused iron overload, and the need for supplemental iron was rare. However, with the widespread introduction of ESAs, it was recognized that supplemental iron was necessary to optimize hemoglobin response and allow reduction of the ESA dose for economic reasons and recent concerns about ESA safety. Iron supplementation was also found to be more efficacious via intravenous compared to oral administration, and the use of intravenous iron has escalated in recent years...
January 2016: Kidney International
https://www.readbyqxmd.com/read/26445673/lactate-kinetics-in-sepsis-and-septic-shock-a-review-of-the-literature-and-rationale-for-further-research
#17
REVIEW
Jason Chertoff, Michael Chisum, Bryan Garcia, Jorge Lascano
Over the last two decades, there have been vast improvements in sepsis-related outcomes, largely resulting from the widespread adoption of aggressive fluid resuscitation and infection control. With increased understanding of the pathophysiology of sepsis, novel diagnostics and resuscitative interventions are being discovered. In recent years, few diagnostic tests like lactate have engendered more attention and research in the sepsis arena. Studies highlighting lactate's prognostic potential for mortality and other outcomes are ubiquitous and largely focus on the early stage of sepsis management, defined as the initial 6 h and widely referred to as the "golden hours...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/26376279/ultrasound-guided-subclavian-vein-catheterization-a-systematic-review-and-meta-analysis-several-facts-need-to-be-noticed
#18
LETTER
Libing Jiang, Mao Zhang, Yuefeng Ma
No abstract text is available yet for this article.
October 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/26261773/steps-to-consider-in-the-approach-and-management-of-critically-ill-patient-with-spontaneous-intracerebral-hemorrhage
#19
REVIEW
Daniel Agustin Godoy, Gustavo Rene Piñero, Patricia Koller, Luca Masotti, Mario Di Napoli
Spontaneous intracerebral hemorrhage is a type of stroke associated with poor outcomes. Mortality is elevated, especially in the acute phase. From a pathophysiological point of view the bleeding must traverse different stages dominated by the possibility of re-bleeding, edema, intracranial hypertension, inflammation and neurotoxicity due to blood degradation products, mainly hemoglobin and thrombin. Neurological deterioration and death are common in early hours, so it is a true neurological-neurosurgical emergency...
August 4, 2015: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26320112/2015-esc-guidelines-for-the-diagnosis-and-management-of-pericardial-diseases-the-task-force-for-the-diagnosis-and-management-of-pericardial-diseases-of-the-european-society-of-cardiology-esc-endorsed-by-the-european-association-for-cardio-thoracic-surgery-eacts
#20
Yehuda Adler, Philippe Charron, Massimo Imazio, Luigi Badano, Gonzalo Barón-Esquivias, Jan Bogaert, Antonio Brucato, Pascal Gueret, Karin Klingel, Christos Lionis, Bernhard Maisch, Bongani Mayosi, Alain Pavie, Arsen D Ristić, Manel Sabaté Tenas, Petar Seferovic, Karl Swedberg, Witold Tomkowski, Stephan Achenbach, Stefan Agewall, Nawwar Al-Attar, Juan Angel Ferrer, Michael Arad, Riccardo Asteggiano, Héctor Bueno, Alida L P Caforio, Scipione Carerj, Claudio Ceconi, Arturo Evangelista, Frank Flachskampf, George Giannakoulas, Stephan Gielen, Gilbert Habib, Philippe Kolh, Ekaterini Lambrinou, Patrizio Lancellotti, George Lazaros, Ales Linhart, Philippe Meurin, Koen Nieman, Massimo F Piepoli, Susanna Price, Jolien Roos-Hesselink, François Roubille, Frank Ruschitzka, Jaume Sagristà Sauleda, Miguel Sousa-Uva, Jens Uwe Voigt, Jose Luis Zamorano
No abstract text is available yet for this article.
November 7, 2015: European Heart Journal
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