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ICU Management & Practice, Volume 21 - Issue 5, 2021 Microbiome in Sepsis and COVID-19 Bacteria play a fundamental role in human life. Given the many roles of gut microbiota in critical illness and other pathological conditions, it is important to target therapeutical interventions to restore, preserve and enrich its composition. Introduction Bacteria play, for better or worse, a fundamental role in human life. As multidrug resistant bacterial infecti...
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Carbapenem Antibiotics for Nosocomial Pneumonia Evidence from previous studies suggests that the treatment of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) with empiric carbapenems is associated with lower mortality rates. However, it has also been reported that the use of carbapenems results in higher rates of clinical failure for pseudomonal pneumonia. This meta-analysis is an updated report with sensitivity analyses and meta-regr...
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EDITORIAL Molnupiravir — A Step toward Orally Bioavailable Therapies for Covid-19 Richard Whitley N Engl J Med December 16, 2021DOI: 10.1056/NEJMe2117814 The Covid-19 pandemic has resulted in substantial global morbidity and mortality as well as disruption of the economies of virtually every country.1 Some of this tragedy could have been averted with the development of deliverable, orally bioavailable, direct-acting antiviral therapeutics. Molnupiravir, t...
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Haemodynamic Monitoring and Management in Critical Care Over the last fifty years, haemodynamic monitoring techniques have progressed quite significantly, moving from bulky sphygmographs to invasive catheters to noninvasive digital monitors that provide continuous values of multiple haemodynamic variables. Haemodynamic monitoring concepts have also changed and have progressed from global macrohaemodynamic monitoring towards a more regional, microcirculatory perfusi...
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Perioperative Dexmedetomidine and Postoperative Delirium Delirium is very common in patients who undergo major cardiac and non-cardiac surgery. Delirium is associated with postoperative mortality, postoperative cognitive dysfunction, increased length of stay in the hospital and postoperative complications and morbidity. A study was conducted to investigate the effect of perioperative administration of dexmedetomidine on the incidence of postoperative delirium in...
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Early vs. Late Awake Prone Positioning in COVID-19 Approximately 25 to 30% of COVID-19 patients develop signs of acute respiratory distress that require higher respiratory support in terms of oxygen therapy, and noninvasive and invasive positive pressure ventilation. Since the beginning of the COVID-19 pandemic, the use of awake prone positioning has increased in the management of patients with COVID-19. Early prone positioning improves oxygenation and pati...
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Simultaneous Management of ARDS and sABI Acute respiratory distress syndrome (ARDS) occurs in approximately 40% of patients with severe acute brain injury (sABI), including acute ischaemic stroke, subarachnoid haemorrhage, intracerebral haemorrhage and traumatic brain injury. It is also a major determinant of morbidity and mortality. With the increase in ARDS cases and reports of neurological complications in COVID-19, there is now a need to manage concomitant s...
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Optimising Early Mobilisation & Rehabilitation in Intensive Care More than forty randomised trials have evaluated early mobilisation and rehabilitation in ICUs in the last decade. These trials usually aim to reduce the incidence of ICU acquired weakness (ICUAW) which is known to be associated with poor long-term survival, poor physical function and decreased quality of life. Eight international guidelines recommend early mobilisation and rehabilitation in inten...
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ICU Management & Practice, Volume 21 - Issue 4, 2021 Sex, Lies and COVID-19 An overview of the impact of gender on the severity of illness, impact and outcomes of COVID-19.The human coronaviruses (HCoVs) include two alpha-CoVs (HCoV-229E and HCoV-NL63) and five beta-coronaviruses (HCoV-OC43, HCoV-HKU1, severe acute respiratory syndrome CoV [SARS-CoV], Middle East respiratory syndrome CoV [MERS-CoV], and most recently (β-CoV SARS-CoV-2). Early data rela...
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Editorials Public health measures for covid-19 Paul P Glasziou, Susan Michie, Atle Fretheim BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2729 (Published 18 November 2021)Cite this as: BMJ 2021;375:n2729 Lack of good research is a pandemic tragedy Although the pandemic has seen remarkable trials for vaccines and drug treatments, much less has been done to evaluate the effects of public health and social measures (PHSMs)1; also known as non-pharmaceutical ...
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