Critical Care
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Simplifying Anticoagulation: Apixaban for VTE in Patients with End-Stage Kidney Disease
There is a lower risk of bleeding with apixaban during the treatment of venous thromboembolism compared to warfarin in patients with end-stage kidney disease.
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Bougie Use in Airway Management in the Critically Ill
Despite significant advances in our understanding of airway management and intubation of the critically ill, this common intensive care unit (ICU) procedure remains high-risk.
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Modifiable Factors Play a Significant Role in the Performance of Spontaneous Awake and Breathing Trials
In this secondary analysis of data from a national intensive care unit collaborative, various non-modifiable and modifiable factors were associated with performance of spontaneous awake and breathing trials.
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Intravenous Fluids in ICU Patients with Septic Shock: Is Restriction the Answer?
In an international, randomized trial of 1,554 patients with septic shock who had already received > 1 liter of intravenous fluids, patients assigned to the restrictive-fluid group compared to the standard-fluid group did not have reduced mortality at 90 days.
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Updates in Stress Ulcer Prophylaxis
The development of esophageal, gastric, and duodenal erosions or ulcers may increase the morbidity and mortality of critically ill patients. Stress ulcer prophylaxis can be administered pharmacologically to prevent gastrointestinal bleeding from the ulcers.
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Informed Consent Requirements May Hinder Innovation in Stroke Treatments
IRBs and regulatory bodies should consider the changing scope of acute stroke care, and collaborate with investigators to design studies that can ethically answer important questions and allow innovation and progress in the field.
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Adults with Developmental Disabilities at Risk for Poor End-of-Life Care
Policies should specify that the wishes of these patients should be known. They should be able to access all medically appropriate care, without bias, and have the right to avoid medical interventions they wish to refuse.
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‘Informed Assent’ for CPR Is Reasonable Approach for Some Hospitalized Patients
This concept was developed to satisfy the right of physicians to initiate DNR orders in futile situations and their duty to communicate to patients and lawful surrogates. Through informed assent, physicians state they will write a DNR order because it would be futile and harmful to the patient to attempt CPR in their current serious illness.
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Family Members of Critically Ill Patients with SARS-CoV-2 Pneumonia Have a High Burden of Symptoms of PTSD
This multicenter cohort study found a high incidence of post-traumatic stress disorder symptoms among family members of COVID-19 patients at three months after the index intensive care unit admission.
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Biden Administration Invests in Pediatric Mental Healthcare Expansion
Announcement made on the same day various organizations call for optimizing resources for pediatric emergencies.