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Dyspnoea, Psychological Trauma and PTSD In a recent review, the authors hypothesise that some patients suffer unnecessary psychological sequelae such as depression, anxiety and post-traumatic stress disorder (PTSD) from dyspnoea that persists despite pharmacologic sedation during severe acute respiratory failure. The authors point out that the primary cause of dyspnoea is not the contraction of respiratory muscles. Air hunger arises from an increase in respiratory...
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Use of Opioids After Intensive Care A study was conducted to evaluate opioid use in the ICU and identify factors associated with chronic opioid use after critical care. It also aimed to determine if chronic opioid use was associated with an increased risk of death.  Over the last few years, opioid misuse has become a major public health issue in many countries. Pharmaceutical companies have been marketing and promoting the use of liberal opioid prescribing for ...
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Genetic Clues to COVID-19 Pneumonia Researchers at Vanderbilt University Medical Center and colleagues have identified genetic factors that increase the risk for developing pneumonia and its severe, life-threatening consequences. Findings are published in the American Journal of Human Genetics. Information about these genetic clues may aid efforts to identify patients with COVID-19 at greatest risk for pneumonia, and enable earlier interventions to prevent se...
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ICU Management & Practice, Volume 20 - Issue 4, 2020 Continuous Monitoring Beyond the ICU - The Rise of Mobile Solutions Post-ICU patients are at high-risk of clinical deterioration. Continuous and mobile monitoring on hospital wards is useful to detect clinical deterioration at an early stage. It may help to prevent serious adverse events and ICU readmission. Most patients discharged from ICUs are old and have co-morbidities. Even when they are young an...
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#EA20: Wellbeing of Healthcare Providers During COVID-19 In a three-part session on burnout and depression of healthcare providers during COVID-19: diagnosis and approach at Euroanaesthesia 2020, Dr. Miodrag Milenovic of University of Belgrade and Clinical Center of Serbia, Emergency Center, talked about the occupational wellbeing in healthcare providers during the pandemic.  Dr. Milenovic highlighted the fact that the field of anaesthesiology is already quite ...
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#EA20: Is Technology the Answer for Perioperative Patient Safety? One of the most enjoyable sessions at Euroanaesthesia 2020 this year was the pro-con debate. The debate this time was on the topic: is technology the final answer for perioperative patient safety? Two experts, Dr. Daniel Arnal from the  Hospital Universitario Fundación Alcorcón, Madrid, Spain, delivered the pro argument, while Prof. William Harrop-Griffiths from Imperial College, London, UK, deli...
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ICU Management & Practice, Volume 20 - Issue 4, 2020 Treatment of Catecholamine Refractory Hypotension in Septic Shock: Beyond First Line Vasopressor Hypotension during septic shock is a strong indicator of patient outcome and mortality. Arginine vasopressin is a naturally produced human hormone with vasoconstriction effect via V1 receptor activation and a short 5-20 minutes half-life and is recommended by the Surviving Sepsis Campaign guidelines to be adde...
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Prevalence and Risk Factors for Delirium in COVID-19 ICU Patients According to findings from a large study, COVID-19 patients admitted to the ICU in the early months of the pandemic had a higher burden of delirium and coma than is typically found in patients with acute respiratory failure. The findings are published in The Lancet Respiratory Medicine. Study investigators tracked the incidence of delirium and coma in 2088 COVID-19 patients admitted in the ICU be...
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Improving Survival of Critical Care Patients With COVID-19 in England Data from the UK suggests that there has been an improvement in the survival of hospitalised patients with COVID-19 in recent months. Case-fatality rate of hospitalised patients declined from 6% in April 2020 to 1.5% by July 2020.  A possible explanation for this shift may be the fact that there has been a shift in the demographics of people admitted with COVID-19. Patients are now younger an...
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EDITORIAL Effect of Oxygen Therapy on Mortality in the ICU Paul J. Young N Engl J Med 2021; 384:1361-1363DOI: 10.1056/NEJMe2101538 Oxygen therapy is a key component of supportive care for patients who have hypoxemic respiratory failure and are being treated in the intensive care unit (ICU). Yet, although oxygen can be lifesaving for patients with severe hypoxemia, overzealous oxygen administration may be harmful. Furthermore, data to inform the use of oxygen t...
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