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In a multicenter study, critically ill patients with initial hyperlactatemia had improved outcomes (including shorter ICU stays and lower adjusted mortality) compared to control patients when they were managed for the first 8 hours with a resuscitation protocol targeted at reducing the lactate level by at least 20% every 2 hours.
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The relationship between blood pressure and cardiovascular events remains controversial, especially in patients with coronary artery disease who may need increased pressures to have adequate myocardial perfusion.
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Gastrointestinal (GI) bleeding is a major complication of dual anti-platelet therapy (DAPT) with aspirin and clopidogrel.
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In this issue: Statins and liver function; dosing timing for thyroxine; rivaroxaban for VTE, DVT, and stroke; echinacea and the common cold; and FDA actions.
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Hyponatremia is frequently seen in patients with left ventricular failure and has recently been shown to be associated with right ventricular dysfunction and worse outcomes in patients with pulmonary hypertension.
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Due to its lack of cardiovascular side effects, the short-acting non-barbiturate sedative, etomidate, has been one of the primary agents used to sedate hypotensive patients during rapid-sequence intubation (RSI).
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In this study from the Mayo Clinic in Rochester, MN, Herasevich et al tested an electronic algorithm that incorporated patient characteristics and ventilator data and notified clinicians immediately when potentially injurious ventilator settings were being used.
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Laboratory studies and clinical data support the concept that prolonged mechanical ventilation (PMV) can induce or worsen lung injury, via activation of inflammatory mediators and/or microvascular fibrin deposition, processes that may be ameliorated by heparin.