Critical Care
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Management of the Cardiac Surgery Patient
The goal of this review is to provide an evidence-based narrative for the management of post-operative patients who have coronary artery bypass graft surgery and heart valve repair/replacement surgeries.
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Frail Older Patients Receiving Higher-Intensity End-of-Life Care
There is an opportunity for targeted interventions for all older patients, especially frail older adults, undergoing emergency general surgery to establish better prognostic understanding and discuss advance care planning before hospital discharge.
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Routine Ethics Consults Helpful if ECMO Is Considered
When a patient is placed on extracorporeal membrane oxygenation (ECMO), usually emergently, families have begun to face the gravity of the situation. Suddenly, ECMO offers new hope. Even though the primary team explains ECMO will be a time-limited trial and a bridge to recovery, transplant, or device, many families remain focused only on the possibility of hope.
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Court Ruling on Life Support Withdrawal Affects Ethics Committees
Hospitals may need to afford more procedural due process when deciding on whether to withhold or withdraw life-sustaining treatment without consent.
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Pediatric Drowning
Pediatric drowning events are associated with consequences varying from transient pulmonary symptoms to devastating neurologic disability. All acute care providers need to be prepared to diagnose and effectively manage a child with this type of injury.
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Multimodal Pain Control Strategy Shows Promise in Trauma Patients
Researchers continue searching for ways to minimize opioid exposure.
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Palliative Care Encounters Ethical Conflicts: Consistent Communication Is Key
Palliative care specialists encounter a wide range of ethical challenges in their day-to-day practice, such as navigating institutional policies, interprofessional conflicts, and resource allocation.
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Policy on Inappropriate Treatment Used in 25% of Ethics Consults
This suggests providers are searching for definitive tools, in addition to the ethics committee, to help resolve difficult end-of-life cases.
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COVID-19 Patients Can Be Managed Safely with Noninvasive Respiratory Strategies
In this retrospective chart review of adult patients hospitalized with COVID-19 over a one-month period, the implementation of a noninvasive respiratory protocol that encouraged high-flow nasal cannula, noninvasive mechanical ventilation, and self-proning did not result in any significant increase in mortality.
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In the Setting of Non-COVID ARDS, Improvement in Oxygenation with Proning Predicts Survival
In this retrospective cohort study, improvement in the PaO2/FiO2 (P/F) ratio by 54% was the optimal cutoff to predict those more likely to be alive at 28 days.