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Although it is understood that good nutrition is essential for normal immune function, wound healing and maintenance of muscle mass and function, and is likely beneficial for overall recovery from the highly catabolic state of acute critical illness, it is less clear when and how best to deliver adequate nutritional support in practice.
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Stopping statins, even briefly, after stroke or cardiovascular surgery increases vascular complications according to 3 new studies.
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With better immunosuppressive therapy and ICU care, invasive aspergillosis is being encountered more often. Making the diagnosis is challenging, especially in lower-risk patients such as those with COPD and cirrhosis.
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In this study of surgical ICU patients in whom chest tubes were placed percutaneously for pneumothorax or sterile pleural effusion, 21% of the tubes were found on chest CT to be in a fissure, and another 9% were intraparenchymal. Only a minority of the malpositions were described in the official radiology reports.
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Patients frequently present to the emergency department with gastrointestinal complaints such as vomiting, abdominal pain, and diarrhea. Identification of a foodborne illness may be very challenging.
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In a mixed population of adult ICU patients who had been intubated for at least 36 hours, administration of 80 mg of methylprednisolone over the 12 hours preceding extubation substantially reduced the incidence of post-extubation laryngeal edema and the need for re-intubation.
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Most cases of acute pericarditis are due to idiopathic or viral causes and have a benign prognosis with symptomatic treatment. How to identify those cases due to specifically treatable causes or those cases not expected to do well would be useful to know.
