Critical Care Alert
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Does Dexmedetomidine Improve Patient Outcomes in Sepsis?
In patients with sepsis requiring mechanical ventilation, use of dexmedetomidine compared with no dexmedetomidine did not result in an improvement in 28-day mortality or ventilator-free days.
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Resilience in the ICU: A Valuable Asset for Families
Interventions that teach resilience may improve family members’ experiences in the ICU.
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Management of Pulmonary Embolism in the ICU
Small, low-risk pulmonary embolism can be treated as an outpatient procedure or with heparin infusion alone, but higher-risk pulmonary embolism cases are managed properly in an ICU. With the introduction of newer modalities of treatment, appropriate risk stratification and the choice of treatment are increasingly complex.
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Assessing Serial Ventilator Settings May Help Reduce Duration of Antibiotic Courses for Suspected Ventilator-associated Pneumonia
In mechanically ventilated patients with stable ventilator settings for at least three days, very short courses of antibiotics (< 3 days) for suspected ventilator-associated pneumonia were associated with similar outcomes when compared to longer courses (> 3 days).
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Prophylactic Steroids Prevent Reintubation in Patients at Risk for Post-extubation Stridor
This meta-analysis demonstrated the administration of steroids between one to 24 hours prior to extubation reduced the risk of reintubation for patients at risk for post-extubation stridor.
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Early Lung Recruitment Reduces Pulmonary Complications
In postoperative cardiac surgery patients with hypoxemia at admission to the ICU, the brief application of an intensive recruitment maneuver followed by lung-protective ventilation was associated with reduced occurrence and severity of pulmonary complications.
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Acute Respiratory Distress Syndrome Treatment Guidelines
This article provides a collaborative, evidence-based guideline for mechanical ventilation in acute respiratory distress syndrome.
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Studying Surrogate Responses Can Improve Communication in Chronic Critical Illness
Qualitative analysis of audio-recorded structured meetings for patients with chronic critical illness revealed six categories of responses that clinicians can use to guide communication.
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Muscle Weakness and Acute Respiratory Distress Syndrome: What Happens After the ICU?
Although increased strength at hospital discharge is associated with improved five-year survival in acute respiratory distress syndrome survivors, weakness at discharge, whether resolving or persistent, is associated with worse subsequent survival.
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2016 Surviving Sepsis Guidelines Update
All ICU clinicians need to review these guidelines, compare them with their current practices, and develop plans for implementation in the near future.