Critical Care Alert
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How Good Is Passive Leg Raise at Predicting Fluid Responsiveness?
In a meta-analysis of 23 clinical trials, passive leg raise was shown to be an excellent predictor of fluid responsiveness.
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ICU Outcomes and Triage in Elderly Patients with Advanced Cancer
Here are the stats for those patients who are 80 years and older.
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Predicting the Success of Prone Positioning with Lung Ultrasound
Lung ultrasound may be useful in predicting which patients with acute respiratory distress syndrome would favorably respond to prone positioning.
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Can Procalcitonin Predict Need for ICU Admission in Community-acquired Pneumonia Patients?
In a prospective cohort study of adults hospitalized with community-acquired pneumonia, higher serum procalcitonin levels on admission were associated with an increased risk of invasive respiratory and/or vasopressor support within 72 hours and improved the performance of pneumonia severity scores in identifying high-risk patients.
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A Perspective on Tidal Volume Reduction in Acute Respiratory Distress Syndrome
Less than 20% of acute respiratory distress syndrome patients were treated at any point during mechanical ventilation with a tidal volume at or below the target used during the NIH ARDSNet trials.
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Novel Oral Anticoagulants in the Critical Care Setting
While the risk of major bleeding complications seems less with novel oral anticoagulants, they present unique challenges in the ICU.
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Acetazolamide in Mechanically Ventilated Patients with COPD: Is There a Benefit?
Compared to placebo, the use of acetazolamide in mechanically ventilated patients with COPD does not significantly reduce the duration of mechanical ventilation.
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Communication Facilitators Potentially Can Improve Care for the Sickest ICU Patients
Highly trained communication facilitators who counseled families and met with physicians and nurses were shown to decrease symptoms of depression in family members at six months and decreased ICU length of stay without affecting mortality.
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Delaying Intubation in Severe Alcohol Withdrawal
Delaying intubation until aspiration or cardiopulmonary decompensation did not affect mortality but increased the incidence of pneumonia and length of stay.
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Patients Rarely Sleep in the ICU
Understanding the mechanisms of sleep deprivation in the ICU may help clinicians modify some of these factors to promote better quality sleep.