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Mashup Score: 3Post-Arrest Care Updates – Are Mild Hypercapnia and a Pan-CT Protocol Useful? | Critical Care Perspectives in Emergency Medicine - 8 month(s) ago
ccpempod September 8, 2023 Care of the patient with ROSC following OHCA can be complex and typically includes a protocolized approach to optimizing oxygenation, ventilation, hemodynamics, early cardiac catheterization for patients with STEMI, seizure detection, and possibly TTM. In this podcast, we review two recent articles that focused on the use of mild hypercapnia compared with…
Source: ccpem.blogCategories: Critical Care, Latest HeadlinesTweet
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Mashup Score: 4Transfusion of red blood cells in venoarterial extracorporeal membrane oxygenation: A multicenter retrospective observational cohort study - 8 month(s) ago
Background Evidence-based recommendations for transfusion in patients with venoarterial extracorporeal membrane oxygenation (VA ECMO) are scarce. The current literature is limited to single-center s…
Source: onlinelibrary.wiley.comCategories: Hem/Oncs, Latest HeadlinesTweet
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Mashup Score: 0
Background Thrombocytopenia, hemorrhage and platelet transfusion are common in patients supported with venoarterial extracorporeal membrane oxygenation (VA ECMO). However, current literature is limited to small single-center experiences with high degrees of heterogeneity. Therefore, we aimed to ascertain in a multicenter study the course and occurrence rate of thrombocytopenia, and to assess the association between thrombocytopenia, hemorrhage and platelet transfusion during VA ECMO. Methods This was a sub-study of a multicenter (N = 16) study on transfusion practices in patients on VA ECMO, in which a retrospective cohort (Jan-2018–Jul-2019) focusing on platelets was selected. The primary outcome was thrombocytopenia during VA ECMO, defined as mild (100–150·109/L), moderate (50–100·109/L) and severe (< 50·109/L). Secondary outcomes included the occurrence rate of platelet transfusion, and the association between thrombocytopenia, hemorrhage and platelet transfusion, assessed through m
Source: ccforum.biomedcentral.comCategories: Critical Care, Latest HeadlinesTweet
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Mashup Score: 0Transcutaneous electrical diaphragmatic stimulation in mechanically ventilated patients: a randomised study - Critical Care - 8 month(s) ago
Background Few specific methods are available to reduce the risk of diaphragmatic dysfunction for patients under mechanical ventilation. The number of studies involving transcutaneous electrical stimulation of the diaphragm (TEDS) is increasing but none report results for diaphragmatic measurements, and they lack power. We hypothesised that the use of TEDS would decrease diaphragmatic dysfunction and improve respiratory muscle strength in patients in ICU. Methods We conducted a controlled trial to assess the impact of daily active electrical stimulation versus sham stimulation on the prevention of diaphragm dysfunction during the weaning process from mechanical ventilation. The evaluation was based on ultrasound measurements of diaphragm thickening fraction during spontaneous breathing trials. We also measured maximal inspiratory muscle pressure (MIP), peak cough flow (PEF) and extubation failure. Results Sixty-six patients were included and randomised using a 1:1 ratio. The mean numbe
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Mashup Score: 1FX06 to rescue SARS-CoV-2-induced acute respiratory distress syndrome: a randomized clinical trial - Critical Care - 8 month(s) ago
Background Vascular leakage is a major feature of acute respiratory distress syndrome (ARDS). We aimed to evaluate the efficacy of FX06, a drug under development that stabilizes interendothelial cell junctions, at reducing vascular leakage during SARS-CoV-2-induced ARDS. Methods This multicenter, double-blinded, randomized trial included adults with COVID-19-associated ARDS who had received invasive mechanical ventilation for < 5 days and were randomized to receive either intravenous FX06 (400 mg/d, for 5 days) or its vehicle as placebo. The primary endpoint was the lowering—from day 1 to day 7—of the transpulmonary thermodilution-derived extravascular lung-water index (EVLWi). Results Twenty-five patients were randomized to receive FX06 and 24 the placebo. Although EVLWi was elevated at baseline (median [IQR] 15.6 mL/kg [13.5; 18.5]), its declines from day 1 to day 7 were comparable for FX06 recipients and controls (respectively, − 1.9 [− 3.3; − 0.5] vs. − 0.8 [− 5.5; − 1.1] mL/kg; es
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Mashup Score: 1Pneumocystis jirovecii pneumonia in intensive care units: a multicenter study by ESGCIP and EFISG - Critical Care - 8 month(s) ago
Background Pneumocystis jirovecii pneumonia (PJP) is an opportunistic, life-threatening disease commonly affecting immunocompromised patients. The distribution of predisposing diseases or conditions in critically ill patients admitted to intensive care unit (ICU) and subjected to diagnostic work-up for PJP has seldom been explored. Materials and methods The primary objective of the study was to describe the characteristics of ICU patients subjected to diagnostic workup for PJP. The secondary objectives were: (i) to assess demographic and clinical variables associated with PJP; (ii) to assess the performance of Pneumocystis PCR on respiratory specimens and serum BDG for the diagnosis of PJP; (iii) to describe 30-day and 90-day mortality in the study population. Results Overall, 600 patients were included in the study, of whom 115 had presumptive/proven PJP (19.2%). Only 8.8% of ICU patients subjected to diagnostic workup for PJP had HIV infection, whereas hematological malignancy, solid
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Mashup Score: 4Nasogastric tube insertion length measurement and tip verification in adults: a narrative review - Critical Care - 8 month(s) ago
Nasogastric feeding tube insertion is a common but invasive procedure most often blindly placed by nurses in acute and chronic care settings. Although usually not harmful, serious and fatal complications with misplacement still occur and variation in practice still exists. These tubes can be used for drainage or administration of fluids, drugs and/or enteral feeding. During blind insertion, it is important to achieve correct tip position of the tube ideally reaching the body of the stomach. If the insertion length is too short, the tip and/or distal side-openings at the end of the tube can be located in the esophagus increasing the risk of aspiration (pneumonia). Conversely, when the insertion length is too long, the tube might kink in the stomach, curl upwards into the esophagus or enter the duodenum. Studies have demonstrated that the most frequently used technique to determine insertion length (the nose–earlobe–xiphoid method) is too short a distance; new safer methods should be use
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Mashup Score: 95Administration of vasopressors through peripheral venous catheters - 8 month(s) ago
Despite advancements in sepsis management, mortality rates remain high. In 2011, 1 in 18 deaths in Canada involved sepsis.[1][1] Delays in achieving adequate mean arterial pressure (MAP) are associated with increased mortality.[2][2] Therefore, the Surviving Sepsis Campaign guideline recommends
Source: www.cmaj.caCategories: Latest Headlines, PediatricsTweet
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Mashup Score: 57Administration of vasopressors through peripheral venous catheters - 8 month(s) ago
Despite advancements in sepsis management, mortality rates remain high. In 2011, 1 in 18 deaths in Canada involved sepsis.[1][1] Delays in achieving adequate mean arterial pressure (MAP) are associated with increased mortality.[2][2] Therefore, the Surviving Sepsis Campaign guideline recommends
Source: www.cmaj.caCategories: Cardiologists, Latest HeadlinesTweet
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Mashup Score: 2Paediatric Point of care ultrasound: Big Kids playing with toys or the future of Paediatric emergency medicine? Part I - 8 month(s) ago
Part 1 of an introduction to paediatric ultrasound in the emergency department from Dr Pete Hulme @Dr_Pete_EmMed @stemlyns #FOAMed
Source: www.stemlynsblog.orgCategories: Hem/Oncs, Latest HeadlinesTweet
Our latest podcast is now available at https://t.co/axV5GndBEa. In this podcast we discuss the recent TAME and CT FIRST trials and their implications for post-arrest care. @JohnGreenwoodMD #FOAMcc #FOAMed