Critical Care Alert
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Mortality and Days Alive Outside Institutions in Older Patients After Tracheostomy with or Without Gastrostomy Tube
Medicare beneficiaries who underwent tracheostomy and gastrostomy tube placement often remained institutionalized beyond three months, with three-, six-, and 12-month mortality greater than 40%, 50%, and 60%, respectively.
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Occult Hypoxemia Is More Common in Black Patients than in White Patients About to Undergo ECMO for Respiratory Failure
In this retrospective analysis of de-identified Extracorporeal Life Support Organization registry data, the prevalence of occult hypoxemia was higher in Black patients than in white patients. Hispanic and Asian patients had a similar prevalence of occult hypoxemia compared to white patients.
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Surviving Sepsis: The New Guidelines
Subsequent revisions of Surviving Sepsis guidelines highlighted the need for early, appropriate antibiotics along with a new focus on initial resuscitation, stressing the importance of dynamic measurements instead of static variables to predict fluid responsiveness. The most recent 2021 revisions continue to stress the importance of these ideals, but they also place an increased emphasis on the hour-1 bundle and improving the care of sepsis patients after they are discharged from the intensive care unit.
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COVID-19 Associated with Significant Increase in Hospital-Acquired Bloodstream Infections
The time period of the COVID-19 pandemic was associated with increases in hospital-onset bloodstream infections, mainly in patients with COVID-19.
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Ketamine vs. Etomidate for Emergency Intubation
In a single-center, open label study, ketamine for emergency intubation compared to etomidate was associated with lower seven-day mortality, although 28-day mortality was similar.
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Awake Prone Positioning for COVID-19-Related Acute Hypoxemic Respiratory Failure
This special feature summarizes the literature associated with awake prone positioning (APP), describes known factors related to successful APP, and highlights current recommendations regarding APP in the setting of COVID-19.
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Prophylactic Post-Extubation Noninvasive Ventilation May Benefit Select Obese Patients
In this post hoc analysis, the use of noninvasive ventilation alternating with high-flow nasal cannula post-extubation decreased the risk of reintubation and death in obese and overweight patients at high risk for reintubation.
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Management of Right Ventricular Failure in the Critically Ill
This review will outline the management of right ventricular failure in the critically ill. -
Midline Catheters May Be a Safer Option than Peripherally Inserted Central Catheters
Whenever possible, use of midline catheters over peripherally inserted central catheters could be safer for patients.
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Patients’ Goals During Long-Term Acute Care Hospital Stays
After a long-term acute care hospital stay, most patients will achieve goals of ventilator liberation, eating, drinking, and speaking, but many will not achieve independence in walking, grooming, toileting, or returning home.