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Icu articles

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7 papers 0 to 25 followers
Jennifer A Frontera, John J Lewin, Alejandro A Rabinstein, Imo P Aisiku, Anne W Alexandrov, Aaron M Cook, Gregory J del Zoppo, Monisha A Kumar, Ellinor I B Peerschke, Michael F Stiefel, Jeanne S Teitelbaum, Katja E Wartenberg, Cindy L Zerfoss
BACKGROUND: The use of antithrombotic agents, including anticoagulants, antiplatelet agents, and thrombolytics has increased over the last decade and is expected to continue to rise. Although antithrombotic-associated intracranial hemorrhage can be devastating, rapid reversal of coagulopathy may help limit hematoma expansion and improve outcomes. METHODS: The Neurocritical Care Society, in conjunction with the Society of Critical Care Medicine, organized an international, multi-institutional committee with expertise in neurocritical care, neurology, neurosurgery, stroke, hematology, hemato-pathology, emergency medicine, pharmacy, nursing, and guideline development to evaluate the literature and develop an evidence-based practice guideline...
February 2016: Neurocritical Care
Thomas G V Cherpanath, Alexander Hirsch, Bart F Geerts, Wim K Lagrand, Mariska M Leeflang, Marcus J Schultz, A B Johan Groeneveld
OBJECTIVE: Passive leg raising creates a reversible increase in venous return allowing for the prediction of fluid responsiveness. However, the amount of venous return may vary in various clinical settings potentially affecting the diagnostic performance of passive leg raising. Therefore we performed a systematic meta-analysis determining the diagnostic performance of passive leg raising in different clinical settings with exploration of patient characteristics, measurement techniques, and outcome variables...
May 2016: Critical Care Medicine
Riza Gultekin, Sean Huang, Ornella Clavisi, Loyal Pattuwage, Thomas C König, Russell Gruen
INTRODUCTION: Providing current, reliable and evidence based information for clinicians and researchers in a synthesised and summarised way can be challenging particularly in the area of traumatic brain injury where a vast number of reviews exists. These reviews vary in their methodological quality and are scattered across varying sources. In this paper, we present an overview of systematic reviews that evaluate the pharmacological interventions in traumatic brain injury (TBI). By doing this, we aim to evaluate the existing evidence for improved outcomes in TBI with pharmacological interventions, and to identify gaps in the literature to inform future research...
March 2016: Injury
Alexis Tabah, Menino Osbert Cotta, Jose Garnacho-Montero, Jeroen Schouten, Jason A Roberts, Jeffrey Lipman, Mark Tacey, Jean-François Timsit, Marc Leone, Jean Ralph Zahar, Jan J De Waele
Antimicrobial de-escalation (ADE) is a strategy to reduce the spectrum of antimicrobials and aims to prevent the emergence of bacterial resistance. We present a systematic review describing the definitions, determinants and outcomes associated with ADE. We included 2 randomized controlled trials and 12 cohort studies. There was considerable variability in the definition of ADE. It was more frequently performed in patients with broad-spectrum and/or appropriate antimicrobial therapy (P= .05 to .002), when more agents were used (P= ...
April 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Asad E Patanwala, Jennifer R Martin, Brian L Erstad
OBJECTIVE: To evaluate the evidence for the use of intravenous ketamine for analgosedation in the intensive care unit. METHODS: MEDLINE and EMBASE were queried from inception until July 2015. Search terms used included ketamine, intensive care, and critical care. The search retrieved 584 articles to be screened for inclusion. The intent was to include randomized controlled studies using sustained intravenous infusions (>24 hours) of ketamine in the critically ill patients...
December 8, 2015: Journal of Intensive Care Medicine
Jared Chiarchiaro, Douglas B White, Natalie C Ernecoff, Praewpannarai Buddadhumaruk, Rachel A Schuster, Robert M Arnold
OBJECTIVES: Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. DESIGN: Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU...
May 2016: Critical Care Medicine
James Leatherman
Acute exacerbations of asthma can lead to respiratory failure requiring ventilatory assistance. Noninvasive ventilation may prevent the need for endotracheal intubation in selected patients. For patients who are intubated and undergo mechanical ventilation, a strategy that prioritizes avoidance of ventilator-related complications over correction of hypercapnia was first proposed 30 years ago and has become the preferred approach. Excessive pulmonary hyperinflation is a major cause of hypotension and barotrauma...
June 2015: Chest
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