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Critical care medicine

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114 papers 100 to 500 followers
https://www.readbyqxmd.com/read/28634641/a-novel-technique-for-ultrasound-guided-central-venous-catheterization-under-short-axis-out-of-plane-approach-stepwise-flashing-with-triangulation
#1
Toshinori Horiuchi, Chie Okuda, Naoko Kurita, Ayako Yamaguchi, Kazuhiko Kitagawa, Masafumi Takeda, Keiichi Sha, Toshihiro Nagahata
In ultrasound-guided central venous catheterization, there is no standard technique either for the needle tip visualization or for the adequate needle angle and entry to the skin with short-axis view under out-of-plane technique. In the present study, we propose a novel technique named "stepwise flashing with triangulation", and the efficacy of this technique is assessed. Before and after a didactic session in which the technique was explained, 12 novice residents were asked to position the needle tip on or into the imitation vessels and to avoid deeper penetration by using an agar tissue phantom with ultrasound guidance...
June 20, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28417882/easl-clinical-practical-guidelines-on-the-management-of-acute-fulminant-liver-failure
#2
(no author information available yet)
The term acute liver failure (ALF) is frequently applied as a generic expression to describe patients presenting with or developing an acute episode of liver dysfunction. In the context of hepatological practice, however, ALF refers to a highly specific and rare syndrome, characterised by an acute abnormality of liver blood tests in an individual without underlying chronic liver disease. The disease process is associated with development of a coagulopathy of liver aetiology, and clinically apparent altered level of consciousness due to hepatic encephalopathy...
May 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28591533/management-of-septic-shock
#3
Rebecca E Berger, Emanuel Rivers, Mitchell M Levy
New England Journal of Medicine, Volume 376, Issue 23, Page 2282-2285, June 2017.
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28575346/ventilation-through-an-extraglottic-tracheal-tube-a-technique-for-deep-extubation-and-airway-control
#4
D Cattano, M Rane
No abstract text is available yet for this article.
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28288031/acute-liver-failure-review-and-update
#5
William Bernal
No abstract text is available yet for this article.
2017: International Anesthesiology Clinics
https://www.readbyqxmd.com/read/28513453/chronic-obstructive-pulmonary-disease
#6
REVIEW
Klaus F Rabe, Henrik Watz
Chronic obstructive pulmonary disease (COPD) kills more than 3 million people worldwide every year. Despite progress in the treatment of symptoms and prevention of acute exacerbations, few advances have been made to ameliorate disease progression or affect mortality. A better understanding of the complex disease mechanisms resulting in COPD is needed. Smoking cessation programmes, increasing physical activity, and early detection and treatment of comorbidities are further key components to reduce the burden of the disease...
May 13, 2017: Lancet
https://www.readbyqxmd.com/read/28439398/a-practical-approach-to-the-pharmacological-management-of-hypertension-in-older-people
#7
REVIEW
Nikesh Parekh, Amy Page, Khalid Ali, Kevin Davies, Chakravarthi Rajkumar
Hypertension is the leading cause of cardiovascular (CV) morbidity and mortality in adults over the age of 65. The first part of this paper is an overview, summarizing the current guidelines on the pharmacological management of hypertension in older adults in Europe and the USA, and evidence from key trials that contributed to the guidelines. In the second part of the paper, we will discuss the major challenges of managing hypertension in the context of multimorbidity, including frailty, orthostatic hypotension (OH), falls and cognitive impairment that are associated with ageing...
April 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28528561/angiotensin-ii-for-the-treatment-of-vasodilatory-shock
#8
Ashish Khanna, Shane W English, Xueyuan S Wang, Kealy Ham, James Tumlin, Harold Szerlip, Laurence W Busse, Laith Altaweel, Timothy E Albertson, Caleb Mackey, Michael T McCurdy, David W Boldt, Stefan Chock, Paul J Young, Kenneth Krell, Richard G Wunderink, Marlies Ostermann, Raghavan Murugan, Michelle N Gong, Rakshit Panwar, Johanna Hästbacka, Raphael Favory, Balasubramanian Venkatesh, B Taylor Thompson, Rinaldo Bellomo, Jeffrey Jensen, Stew Kroll, Lakhmir S Chawla, George F Tidmarsh, Adam M Deane
Background Vasodilatory shock that does not respond to high-dose vasopressors is associated with high mortality. We investigated the effectiveness of angiotensin II for the treatment of patients with this condition. Methods We randomly assigned patients with vasodilatory shock who were receiving more than 0.2 μg of norepinephrine per kilogram of body weight per minute or the equivalent dose of another vasopressor to receive infusions of either angiotensin II or placebo. The primary end point was a response with respect to mean arterial pressure at hour 3 after the start of infusion, with response defined as an increase from baseline of at least 10 mm Hg or an increase to at least 75 mm Hg, without an increase in the dose of background vasopressors...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28506136/predictors-to-intravenous-fluid-responsiveness
#9
Jorge Iván Alvarado Sánchez, William Fernando Amaya Zúñiga, Manuel Ignacio Monge García
Management with intravenous fluids can improve cardiac output in some surgical patients. Management with static preload indicators, such as central venous pressure and pulmonary artery occlusion pressure, has not demonstrated a suitable relationship with changes in the cardiac output induced by intravenous fluid therapy. Dynamic indicators, such as the variability of arterial pulse pressure or stroke volume variation, have demonstrated a suitable relationship. Since improvement in cardiac output does not guarantee an adequate perfusion pressure, in patients with hypotension, it is also necessary to know whether arterial pressure will also increase with intravenous fluid therapy...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28523563/assessment-of-endothelial-cell-function-and-physiological-microcirculatory-reserve-by-video-microscopy-using-a-topical-acetylcholine-and-nitroglycerin-challenge
#10
Matthias Peter Hilty, Jacqueline Pichler, Bulent Ergin, Urs Hefti, Tobias Michael Merz, Can Ince, Marco Maggiorini
BACKGROUND: Assessment of the microcirculation is a promising target for the hemodynamic management of critically ill patients. However, just as the sole reliance on macrocirculatory parameters, single static parameters of the microcirculation may not represent a sufficient guide. Our hypothesis was that by serial topical application of acetylcholine (ACH) and nitroglycerin (NG), the sublingual microcirculation can be challenged to determine its endothelial cell-dependent and smooth muscle-dependent physiological reserve capacity...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28555411/the-top-ten-unknowns-in-paediatric-mechanical-ventilation
#11
Peter C Rimensberger, Ira M Cheifetz, Martin C J Kneyber
No abstract text is available yet for this article.
May 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28432665/systemic-and-microcirculatory-effects-of-blood-transfusion-in-experimental-hemorrhagic-shock
#12
Gonzalo Ferrara, Vanina S Kanoore Edul, Héctor S Canales, Enrique Martins, Carlos Canullán, Gastón Murias, Mario O Pozo, Juan F Caminos Eguillor, María G Buscetti, Can Ince, Arnaldo Dubin
BACKGROUND: The microvascular reperfusion injury after retransfusion has not been completely characterized. Specifically, the question of heterogeneity among different microvascular beds needs to be addressed. In addition, the identification of anaerobic metabolism is elusive. The venoarterial PCO2 to arteriovenous oxygen content difference ratio (Pv-aCO2/Ca-vO2) might be a surrogate for respiratory quotient, but this has not been validated. Therefore, our goal was to characterize sublingual and intestinal (mucosal and serosal) microvascular injury after blood resuscitation in hemorrhagic shock and its relation with O2 and CO2 metabolism...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28265454/fluid-resuscitation-in-haemorrhagic-shock-in-combat-casualties
#13
REVIEW
Parli R Ravi, Bipin Puri
This brief update reviews the recent literature available on fluid resuscitation from hemorrhagic shock and considers the applicability of this evidence for use in resuscitation of combat casualties in the combat casualty care (CCC) environment. A number of changes need to be incorporated in the CCC guidelines: (1) dried plasma (DP) is added as an option when other blood components or whole blood are not available; (2) the wording is clarified to emphasize that Hetastarch is a less desirable option than whole blood, blood components, or DP and should be used only when these preferred options are not available; (3) the use of blood products in certain tactical field care settings where this option might be feasible (FSC, GH) is discussed; (4) 1:1:1 damage control resuscitation (DCR) with plasma: packed red blood cells (PRBC): platelets is preferred to 1:1 DCR with plasma: PRBC when platelets are available; and (5) the 30-min wait between increments of resuscitation fluid administered to achieve clinical improvement or target blood pressure has been eliminated...
2017: Disaster and Military Medicine
https://www.readbyqxmd.com/read/28442101/ultrasound-guidelines-emergency-point-of-care-and-clinical-ultrasound-guidelines-in-medicine
#14
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
May 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28486864/practical-use-of-lactate-levels-in-the-intensive-care
#15
Eva E Vink, Jan Bakker
Hyperlactatemia is a strong predictor of mortality in diverse populations of critically ill patients. In this article, we will give an overview of how lactate is used in the intensive care unit. We describe the use of lactate as a predictor of outcome, as a marker to initiate therapy and to monitor adequacy of initiated treatments.
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28455343/2017-acc-aha-hfsa-focused-update-of-the-2013-accf-aha-guideline-for-the-management-of-heart-failure-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-failure-society-of-america
#16
REVIEW
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Monica M Colvin, Mark H Drazner, Gerasimos S Filippatos, Gregg C Fonarow, Michael M Givertz, Steven M Hollenberg, JoAnn Lindenfeld, Frederick A Masoudi, Patrick E McBride, Pamela N Peterson, Lynne Warner Stevenson, Cheryl Westlake
No abstract text is available yet for this article.
April 28, 2017: Circulation
https://www.readbyqxmd.com/read/28430717/multilateral-functional-alterations-of-human-neutrophils-in-sepsis-from-the-point-of-diagnosis-to-the-seventh-day
#17
Akira Endo, Miko Okamura, Shunsuke Yoshikawa, Yasuhiro Otomo, Tomohiro Morio
Neutrophil functional changes caused by sepsis itself and their time-course variation have not been fully elucidated because previous studies targeted patients who had received therapeutic interventions. We explored the multilateral functions of circulating neutrophils in patients with severe sepsis or septic shock who had not yet undergone interventions, and followed their changes. Patients were treated based on the Surviving Sepsis Campaign Guidelines 2012. Neutrophil functions were evaluated on days 0 (before therapeutic intervention), 3, and 7 in fifty-nine sepsis patients...
April 20, 2017: Shock
https://www.readbyqxmd.com/read/28385477/espen-guideline-clinical-nutrition-in-surgery
#18
Arved Weimann, Marco Braga, Franco Carli, Takashi Higashiguchi, Martin Hübner, Stanislaw Klek, Alessandro Laviano, Olle Ljungqvist, Dileep N Lobo, Robert Martindale, Dan L Waitzberg, Stephan C Bischoff, Pierre Singer
Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidance of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, early enteral feeding is especially relevant for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e...
June 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28385280/recommendations-on-the-echocardiographic-assessment-of-aortic-valve-stenosis-a-focused-update-from-the-european-association-of-cardiovascular-imaging-and-the-american-society-of-echocardiography
#19
Helmut Baumgartner, Judy Hung, Javier Bermejo, John B Chambers, Thor Edvardsen, Steven Goldstein, Patrizio Lancellotti, Melissa LeFevre, Fletcher Miller, Catherine M Otto
Echocardiography is the key tool for the diagnosis and evaluation of aortic stenosis. Because clinical decision-making is based on the echocardiographic assessment of its severity, it is essential that standards are adopted to maintain accuracy and consistency across echocardiographic laboratories. Detailed recommendations for the echocardiographic assessment of valve stenosis were published by the European Association of Echocardiography and the American Society of Echocardiography in 2009. In the meantime, numerous new studies on aortic stenosis have been published with particular new insights into the difficult subgroup of low gradient aortic stenosis making an update of recommendations necessary...
April 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28243715/volume-replacement-during-trauma-resuscitation-a-brief-synopsis-of-current-guidelines-and-recommendations
#20
REVIEW
M Maegele, M Fröhlich, M Caspers, S Kaske
INTRODUCTION: Intravascular volume and fluid replacement are still cornerstones to correct fluid deficits during early trauma resuscitation, but optimum strategies remain under debate. METHODS: A synopsis of best current knowledge with reference to the following guidelines and recommendations is presented: (1) The European Guideline on Management of Major Bleeding and Coagulopathy following Trauma (fourth edition), (2) S3 Guideline on Treatment of Patients with Severe and Multiple Injuries [English Version of the German Guideline S3 Leitlinie Polytrauma/Schwerverletzten-Behandlung/AWMF Register-Nr...
February 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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