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VIEWPOINT| VOLUME 9, ISSUE 8, P933-936, AUGUST 01, 2021 The Berlin definition of acute respiratory distress syndrome: should patients receiving high-flow nasal oxygen be included? Michael A Matthay, B Taylor Thompson, Lorraine B Ware Lancet Respir Med 2021; 9: 933-936 Summary The 2012 Berlin definition of acute respiratory distress syndrome (ARDS) provided validated support for three levels of initial arterial hypoxaemia that correlated with ...
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Protective Ventilation and Outcomes in Patients with COVID-19 The coronavirus pandemic continues to be a global health issue. Clinical outcomes data of patients from China, Europe and the U.S. show high mortality among critically ill patients with COVID-19, especially those who required mechanical ventilation. Among patients with COVID-19, approximately 5% develop respiratory failure that requires ventilatory support. However, very little is known about the impa...
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Passive Leg Raising in Out-of-Hospital Cardiac Arrest Survival among patients with out-of-hospital cardiac arrest (OHCA) is typically quite low. Survival in OHCA is dependent on several factors, including the performance of early bystander cardiopulmonary resuscitation (CPR), the use of public automatic external defibrillators (AEDs), and the performance of high-quality CPR or the post-resuscitation care provided in the hospital. High-quality CPR that optimises car...
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FRISC Study: Fluid and Resuscitation Protocols in Sepsis-Induced Hypotension in Cirrhosis One of the most common causes of hospitalisation and mortality in patients with cirrhosis is sepsis and septic shock. However, despite the routine presence of this condition, there is very limited data on the choice of fluid and resuscitation protocols in sepsis-induced hypotension in cirrhosis. The Fluid Resuscitation in Sepsis Induced Hypotension ...
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Editorial August 31, 2021 Titrating Oxygen Therapy in Critically Ill Patients Martin Urner, Carolyn S. Calfee, Eddy Fan JAMA. Published online August 31, 2021. doi:10.1001/jama.2021.9843 The development of oxygen therapy is one of the major advances of modern medicine. Oxygen therapy laid the groundwork for intensive care medicine as a specialty and has saved millions of lives. During the COVID-19 pandemic, millions of patients survived due to p...
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Viewpoint July 30, 2021 The Increasing Role of Physician Practices as Bill Collectors: Destined for Failure A. Jay Holmgren, David Cutler, Ateev Mehrotra JAMA. Published online July 30, 2021. doi:10.1001/jama.2021.12191 Through increasing deductibles, coinsurance, and co-payments, the privately insured population in the US is responsible for a larger share of health care out-of-pocket costs. Although many studies have examined the effects on pat...
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ICU Management & Practice, Volume 20 - Issue 3, 2020 Vitamin D in Critical Illness – Fifty Shades of VIOLET Did the VITDALIZE study and the VIOLET study manage to answer some of the questions regarding vitamin D deficiency and its impact on critically ill patients? Experts compare the findings and present an overview. Introduction Vitamin D deficiency is very common in the ICU (usually >60%) because many critically ill patients were already chronic...
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JAMA Insights August 2, 2021 Cognitive Decline Associated With Anesthesia and Surgery in Older Patients Susana Vacas, Daniel J. Cole, Maxime Cannesson JAMA. Published online August 2, 2021. doi:10.1001/jama.2021.4773 In the last decade, the population aged 65 years and older increased by 34.2% in the US and now accounts for a disproportionate number of surgical procedures requiring anesthesia. Among these patients, aging causes a number of chang...
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Renal Replacement Therapy in Critically Ill Patients with AKI Many critical care patients with severe acute kidney injury (AKI), especially those who develop refractory complications, receive renal replacement therapy (RRT). However, when RRT should be initiated for these patients remains unclear. There is a consensus that in patients with urgent or refractory complications, RRT should be started. However, the question is: should it be started earlier in the course...
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Culture-Negative and Culture-Positive Sepsis or Septic Shock Incidence of sepsis and septic shock has been increasing consistently, and the morbidity and mortality associated with this is an area of concern. Mortality from sepsis and septic shock is quite high, ranging between 20 to 40%. Guidelines for sepsis and septic shock recommend the application of broad-spectrum antibiotics. There is clinical evidence that time to effective antibiotic therapy could reduce pa...
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