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EDITORIAL
Marc Bonten
No abstract text is available yet for this article.
December 20, 2022: JAMA
#22
REVIEW
Daniel De Backer, Nadia Aissaoui, Maurizio Cecconi, Michelle S Chew, André Denault, Ludhmila Hajjar, Glenn Hernandez, Antonio Messina, Sheila Nainan Myatra, Marlies Ostermann, Michael R Pinsky, Jean-Louis Teboul, Philippe Vignon, Jean-Louis Vincent, Xavier Monnet
In critically ill patients, fluid infusion is aimed at increasing cardiac output and tissue perfusion. However, it may contribute to fluid overload which may be harmful. Thus, volume status, risks and potential efficacy of fluid administration and/or removal should be carefully evaluated, and monitoring techniques help for this purpose. Central venous pressure is a marker of right ventricular preload. Very low values indicate hypovolemia, while extremely high values suggest fluid harmfulness. The pulmonary artery catheter enables a comprehensive assessment of the hemodynamic profile and is particularly useful for indicating the risk of pulmonary oedema through the pulmonary artery occlusion pressure...
October 2022: Intensive Care Medicine
#23
Christiaan Diederik Mathijs Wijers, Ryan J Stark
Introduction: During sepsis and septic shock, the host's immune systems generate an overwhelming and often, detrimental, inflammatory response. Part of this response results in significant alterations in blood flow and vasomotor tone regulated in part by endothelial and vascular smooth muscle cells. Here, we report on a series of 3 pediatric patients for whom vascular response was assessed by laser doppler perfusion coupled to iontophoresis over the first 2 weeks after hospitalization for septic shock to demonstrate similarities and dissimilarities in the vascular response...
2022: Frontiers in Pediatrics
#24
REVIEW
Padmastuti Akella, Louis P Voigt, Sanjay Chawla
Since the inception of critical care medicine and artificial ventilation, literature and research on weaning has transformed daily patient care in intensive care units (ICU). As our knowledge of mechanical ventilation (MV) improved, so did the need to study patient-ventilator interactions and weaning predictors. Randomized trials have evaluated the use of protocol-based weaning (vs. usual care) to study the duration of MV in ICUs, different techniques to conduct spontaneous breathing trials (SBT), and strategies to eventually extubate a patient whose initial SBT failed...
November 2022: Journal of Intensive Care Medicine
#25
REVIEW
Silvio Borrelli, Ida Matarazzo, Eugenio Lembo, Laura Peccarino, Claudia Annoiato, Maria Rosaria Scognamiglio, Andrea Foderini, Chiara Ruotolo, Aldo Franculli, Federica Capozzi, Pavlo Yavorskiy, Fatme Merheb, Michele Provenzano, Gaetano La Manna, Luca De Nicola, Roberto Minutolo, Carlo Garofalo
Increasing potassium intake ameliorates blood pressure (BP) and cardiovascular (CV) prognoses in the general population; therefore the World Health Organization recommends a high-potassium diet (90-120 mEq/day). Hyperkalaemia is a rare condition in healthy individuals due to the ability of the kidneys to effectively excrete dietary potassium load in urine, while an increase in serum K+ is prevalent in patients with chronic kidney disease (CKD). Hyperkalaemia prevalence increases in more advanced CKD stages, and is associated with a poor prognosis...
June 7, 2022: International Journal of Molecular Sciences
#26
REVIEW
Romain Persichini, Christopher Lai, Jean-Louis Teboul, Imane Adda, Laurent Guérin, Xavier Monnet
Venous return is the flow of blood from the systemic venous network towards the right heart. At steady state, venous return equals cardiac output, as the venous and arterial systems operate in series. However, unlike the arterial one, the venous network is a capacitive system with a high compliance. It includes a part of unstressed blood, which is a reservoir that can be recruited via sympathetic endogenous or exogenous stimulation. Guyton's model describes the three determinants of venous return: the mean systemic filling pressure, the right atrial pressure and the resistance to venous return...
May 24, 2022: Critical Care: the Official Journal of the Critical Care Forum
#27
REVIEW
Respiratory Drive, Dyspnea, and Silent Hypoxemia: A Physiological Review in the Context of COVID-19.
Richard H Kallet, Richard D Branson, Michael S Lipnick
Infection with SARS-CoV-2 in select individuals results in viral sepsis, pneumonia, and hypoxemic respiratory failure, collectively known as COVID-19. In the early months of the pandemic, the combination of novel disease presentation, enormous surges of critically ill patients, and severity of illness lent to early observations and pronouncements regarding COVID-19 that could not be scientifically validated owing to crisis circumstances. One of these was a phenomenon referred to as "happy hypoxia." Widely discussed in the lay press, it was thought to represent a novel and perplexing phenomenon: severe hypoxemia coupled with the absence of respiratory distress and dyspnea...
October 2022: Respiratory Care
#28
REVIEW
Howard Kirshner, Matthew Schrag
PURPOSE OF REVIEW: Intracerebral hemorrhage (ICH) represents about 15% of all strokes in the USA, but almost 50% of fatal strokes. There are many causes of ICH, but the most common are hypertension and cerebral amyloid angiopathy. This review will discuss new advances in the treatment of intracerebral hemorrhage. RECENT FINDINGS: The treatment of ICH focuses on management of edema, aggressive blood pressure reduction, and correction of coagulopathy. Early initiation of supportive medical therapies, including blood pressure management, in a neurological intensive care unit reduces mortality, but at present there is no definitive, curative therapy analogous to mechanical thrombectomy for ischemic stroke...
October 2, 2021: Current Neurology and Neuroscience Reports
#29
REVIEW
S Magder
Measurement of arterial pressure is one of the most basic elements of patient management. Arterial pressure is determined by the volume ejected by the heart into the arteries, the elastance of the walls of the arteries, and the rate at which the blood flows out of the arteries. This review will discuss the three forces that determine the pressure in a vessel: elastic, kinetic, and gravitational energy. Emphasis will be placed on the importance of the distribution of arterial resistances, the elastance of the walls of the large vessels, and critical closing pressures in small arteries and arterioles...
October 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
#30
REVIEW
Laurent Papazian, Cécile Aubron, Laurent Brochard, Jean-Daniel Chiche, Alain Combes, Didier Dreyfuss, Jean-Marie Forel, Claude Guérin, Samir Jaber, Armand Mekontso-Dessap, Alain Mercat, Jean-Christophe Richard, Damien Roux, Antoine Vieillard-Baron, Henri Faure
Fifteen recommendations and a therapeutic algorithm regarding the management of acute respiratory distress syndrome (ARDS) at the early phase in adults are proposed. The Grade of Recommendation Assessment, Development and Evaluation (GRADE) methodology has been followed. Four recommendations (low tidal volume, plateau pressure limitation, no oscillatory ventilation, and prone position) had a high level of proof (GRADE 1 + or 1 -); four (high positive end-expiratory pressure [PEEP] in moderate and severe ARDS, muscle relaxants, recruitment maneuvers, and venovenous extracorporeal membrane oxygenation [ECMO]) a low level of proof (GRADE 2 + or 2 -); seven (surveillance, tidal volume for non ARDS mechanically ventilated patients, tidal volume limitation in the presence of low plateau pressure, PEEP > 5 cmH2O, high PEEP in the absence of deleterious effect, pressure mode allowing spontaneous ventilation after the acute phase, and nitric oxide) corresponded to a level of proof that did not allow use of the GRADE classification and were expert opinions...
June 13, 2019: Annals of Intensive Care
#31
REVIEW
Richard H Kallet
Contemplating the future should be grounded in history. The rise of post-polio ICUs was inextricably related to mechanical ventilation. Critically ill patients who developed acute respiratory failure often had "congestive atelectasis" (ie, a term used to describe ARDS prior to 1967). Initial mechanical ventilation strategies for treating this condition and others inadvertently led to ventilator-induced lung injury. Both injurious ventilation and later use of overly cautious weaning practices resulted from both limited technology and understanding of ARDS and other aspects of critical illness...
June 2022: Respiratory Care
#32
JOURNAL ARTICLE
Myra H Wyckoff, Eunice M Singletary, Jasmeet Soar, Theresa M Olasveengen, Robert Greif, Helen G Liley, David Zideman, Farhan Bhanji, Lars W Andersen, Suzanne R Avis, Khalid Aziz, Jason C Bendall, David C Berry, Vere Borra, Bernd W Böttiger, Richard Bradley, Janet E Bray, Jan Breckwoldt, Jestin N Carlson, Pascal Cassan, Maaret Castrén, Wei-Tien Chang, Nathan P Charlton, Adam Cheng, Sung Phil Chung, Julie Considine, Daniela T Costa-Nobre, Keith Couper, Katie N Dainty, Peter G Davis, Maria Fernanda de Almeida, Allan R de Caen, Edison F de Paiva, Charles D Deakin, Therese Djärv, Matthew J Douma, Ian R Drennan, Jonathan P Duff, Kathryn J Eastwood, Jonathan L Epstein, Raffo Escalante, Jorge G Fabres, Joe Fawke, Judith C Finn, Elizabeth E Foglia, Fredrik Folke, Karoline Freeman, Elaine Gilfoyle, Craig A Goolsby, Amy Grove, Ruth Guinsburg, Tetsuo Hatanaka, Mary Fran Hazinski, George S Heriot, Karen G Hirsch, Mathias J Holmberg, Shigeharu Hosono, Ming-Ju Hsieh, Kevin K C Hung, Cindy H Hsu, Takanari Ikeyama, Tetsuya Isayama, Vishal S Kapadia, Mandira Kawakami, Han-Suk Kim, David A Kloeck, Peter J Kudenchuk, Anthony T Lagina, Kasper G Lauridsen, Eric J Lavonas, Andrew S Lockey, Carolina Malta Hansen, David Markenson, Tasuku Matsuyama, Christopher J D McKinlay, Amin Mehrabian, Raina M Merchant, Daniel Meyran, Peter T Morley, Laurie J Morrison, Kevin J Nation, Michael Nemeth, Robert W Neumar, Tonia Nicholson, Susan Niermeyer, Nikolaos Nikolaou, Chika Nishiyama, Brian J O'Neil, Aaron M Orkin, Osokogu Osemeke, Michael J Parr, Catherine Patocka, Jeffrey L Pellegrino, Gavin D Perkins, Jeffrey M Perlman, Yacov Rabi, Joshua C Reynolds, Giuseppe Ristagno, Charles C Roehr, Tetsuya Sakamoto, Claudio Sandroni, Taylor Sawyer, Georg M Schmölzer, Sebastian Schnaubelt, Federico Semeraro, Markus B Skrifvars, Christopher M Smith, Michael A Smyth, Roger F Soll, Takahiro Sugiura, Sian Taylor-Phillips, Daniele Trevisanuto, Christian Vaillancourt, Tzong-Luen Wang, Gary M Weiner, Michelle Welsford, Jane Wigginton, Jonathan P Wyllie, Joyce Yeung, Jerry P Nolan, Katherine M Berg
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts...
November 5, 2021: Resuscitation
#33
REVIEW
Maria L Buis, Nigel M Turner
In this educational article, we summarize the changes in the new European Resuscitation Council guidelines for Pediatric Life Support, emphasizing the most important aspects for the anesthesiologist. Among these are: the use of two-thumb-encircling technique for thorax compressions in infants, 10 ml/kg as the standard volume fluid bolus and ventilation after intubation at an age-dependent rate. Using a fictitious case, we present a point-by-point summary of the changes and briefly mention some of the evidence behind them, referring the reader to the full guidelines for further evidence...
April 2022: Paediatric Anaesthesia
#34
JOURNAL ARTICLE
Derek C Angus, Andrew B Bindman
No abstract text is available yet for this article.
January 11, 2022: JAMA
#35
REVIEW
Alberto Zanetto, Sarah Shalaby, Paolo Feltracco, Martina Gambato, Giacomo Germani, Francesco Paolo Russo, Patrizia Burra, Marco Senzolo
Gastrointestinal bleeding is one of the most relevant causes of death in patients with cirrhosis and clinically significant portal hypertension, with gastroesophageal varices being the most frequent source of hemorrhage. Despite survival has improved thanks to the standardization on medical treatment aiming to decrease portal hypertension and prevent infections, mortality remains significant. In this review, our goal is to discuss the most recent advances in the management of esophageal variceal hemorrhage in cirrhosis with specific attention to the treatment algorithms involving the use of indirect measurement of portal pressure (HVPG) and transjugular intrahepatic portosystemic shunt (TIPS), which aim to further reduce mortality in high-risk patients after acute variceal hemorrhage and in the setting of secondary prophylaxis...
August 25, 2021: Journal of Clinical Medicine
#36
JOURNAL ARTICLE
Robert S O'Shea, Perica Davitkov, Cynthia W Ko, Anita Rajasekhar, Grace L Su, Shahnaz Sultan, Alina M Allen, Yngve Falck-Ytter
No abstract text is available yet for this article.
November 2021: Gastroenterology
#37
REVIEW
Danial Sharifi Kia, Kang Kim, Marc A Simon
Pulmonary arterial hypertension (PAH) is a disease resulting in increased right ventricular (RV) afterload and RV remodeling. PAH results in altered RV structure and function at different scales from organ-level hemodynamics to tissue-level biomechanical properties, fiber-level architecture, and cardiomyocyte-level contractility. Biomechanical analysis of RV pathophysiology has drawn significant attention over the past years and recent work has found a close link between RV biomechanics and physiological function...
2021: Frontiers in Physiology
#38
REVIEW
Ernest E Moore, Hunter B Moore, Lucy Z Kornblith, Matthew D Neal, Maureane Hoffman, Nicola J Mutch, Herbert Schöchl, Beverley J Hunt, Angela Sauaia
Uncontrolled haemorrhage is a major preventable cause of death in patients with traumatic injury. Trauma-induced coagulopathy (TIC) describes abnormal coagulation processes that are attributable to trauma. In the early hours of TIC development, hypocoagulability is typically present, resulting in bleeding, whereas later TIC is characterized by a hypercoagulable state associated with venous thromboembolism and multiple organ failure. Several pathophysiological mechanisms underlie TIC; tissue injury and shock synergistically provoke endothelial, immune system, platelet and clotting activation, which are accentuated by the 'lethal triad' (coagulopathy, hypothermia and acidosis)...
April 29, 2021: Nature Reviews. Disease Primers
#39
REVIEW
Blaithin A McMahon, Lakhmir S Chawla
Loop diuretics are among the most widely used drugs worldwide and are commonly employed in the management of complications associated with acute kidney injury (AKI), namely volume overload and electrolyte management. The use of loop diuretics in critically ill patients with AKI is paramount to preventing or treating pulmonary edema. The naturetic response to a loop diuretic is based on its unique renal pharmacology. Our review article summarizes the pharmacology of furosemide in the intact nephron and discusses how this response might be altered by the presence of AKI...
December 2021: Renal Failure
#40
JOURNAL ARTICLE
Marianna Sockrider, Lisa Roessel, Karen A Fagan, Mark Gillespie
No abstract text is available yet for this article.
March 15, 2021: American Journal of Respiratory and Critical Care Medicine
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