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Early vs Late Tracheostomy and Ventilator-Associated Pneumonia Surgically opening the windpipe, or trachea, within the first seven days of the start of mechanical ventilation decreases the time patients spend on ventilators, shortens their ICU stay and lowers their risk of ventilator-associated pneumonia, according to a new systematic review. "We analysed the existing medical literature to unravel a question that is very pertinent to adult critical care," said s...
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Original Investigation October 11, 2021 Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial Jean M. Connors, Maria M. Brooks, Frank C. Sciurba, et al JAMA. Published online October 11, 2021. doi:10.1001/jama.2021.17272 Abstract Importance  Acutely ill inpatients with COVID-19 typically receive antithrombotic therapy, although the ris...
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Original Investigation September 3, 2021 Surveillance for Adverse Events After COVID-19 mRNA Vaccination Nicola P. Klein, Ned Lewis, Kristin Goddard, et al JAMA. 2021;326(14):1390-1399. doi:10.1001/jama.2021.15072 Abstract Importance  Safety surveillance of vaccines against COVID-19 is critical to ensure safety, maintain trust, and inform policy. Objectives  To monitor 23 serious outcomes weekly, using comprehensive health record...
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RAPID Trial: Therapeutic Heparin vs Prophylactic Heparin in COVID-19 Patients A study was conducted to evaluate the effects of therapeutic heparin compared with prophylactic heparin among moderately ill patients with COVID-19 admitted to the hospital. Heparin has anticoagulant properties, anti-inflammatory effects and potential antiviral effects and may also improve endothelial function. Early initiation of therapeutic heparin can decrease the thrombo-inflammato...
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Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study—a randomized clinical trial Julien Bohé, Hassane Abidi, Vincent Brunot, et al Intensive Care Med Published: 29 September 2021 Abstract Purpose Hyperglycaemia is an adaptive response to stress commonly observed in critical illness. Its management remains debated in the intensive care unit (ICU). Individualising hyperglycaemia management, by targeting the patie...
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Prone Positioning During ECMO for ARDS There is sufficient evidence to show that prone positioning improves oxygenation and respiratory mechanics and is also associated with lower mortality in patients with moderate to severe ARDS. However, some patients can develop refractory hypoxaemia and hypercapnia that could require the use of venovenous extracorporeal membrane oxygenation (VV-ECMO) support and need to be cared for in a supine position. Hence, the physiologic...
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Effect of oral chlorhexidine de-adoption and implementation of an oral care bundle on mortality for mechanically ventilated patients in the intensive care unit (CHORAL): a multi-center stepped wedge cluster-randomized controlled trial Craig M. Dale, Louise Rose, Sarah Carbone, et al Intensive Care Med Published: 05 October 2021 Abstract Purpose Oral chlorhexidine is used widely for mechanically ventilated patients to prevent pneumonia, but recent studies sh...
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AKI in Critically Ill Patients With COVID-19 Acute kidney injury is highly prevalent among severely ill COVID-19 patients. However, there is very limited data on the progression of AKI and long-term outcomes in these patients. In this study, researchers aimed to describe the prevalence and risk factors for the development of acute kidney injury, its clinical course and progression and renal recovery or dialysis dependence and survival. The study was conducted...
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ONLINE FIRST (FREE ACCESS) LATEST ARTICLES OPEN ACCESS ~ OriginalRole of total lung stress on the progression of early COVID-19 pneumoniaCoppola S. et al. Conference Reports and Expert PanelCritically ill cancer patient’s resuscitation: a Belgian/French societies’ consensus conferenceMeert A-P. et al.  EditorialThe goal of personalized glucose control in the critically ill remains elusiveKrinsley J.S., Deane A.M. and Gunst J. Imaging in Intensive Care Medic...
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Ethics in Extracorporeal Life Support Extracorporeal life support has had a significant impact on modern medicine. However, the use of this technology has significant ethical challenges. In this review, the authors identify three ethical discourses: trials and evidence accompanying the use of ECLS, the ECLS allocation, decision-making and limiting care and death on ECLS and ECLS in organ donation. They then provide a narrative synthesis of all major arguments ex...
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