Critical Care
RSSArticles
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Vasopressin Use in Septic Shock
Current management of septic shock includes early administration of intravenous fluids, antimicrobial agents, and vasopressor support. While norepinephrine is recommended as the first-line vasopressor for septic shock in the 2016 Surviving Sepsis Campaign guidelines, vasopressin is a second-line vasopressor option that may be added.
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Penetrating Extremity Trauma: Part II
Part I of this series discussed etiology, initial field management, and emergency department evaluation of penetrating extremity trauma. This article will cover the mangled extremity, recognizing and managing vascular injuries, imaging approach, and emergency department management of these injuries.
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Difficult Airway Intubation With Flexible Bronchoscope as a Guide
In this prospective study, use of a flexible bronchoscope as a flexible stylet and a Glidescope to provide visual guidance while intubating patients in the operating room was associated with shorter time to intubation than the use of Glidescope alone.
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Organ Donation: Perspective for the Intensivist
Organ donation and transplantation are important and lifesaving procedures.The complexities of management include determination of death, communication with families, pre-procurement optimization of potential donors, and bereavement support for families.
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Decision-Making Capacity in the ICU
A multicenter, one-day prevalence, prospective, observational, double-blind study in 19 ICUs revealed that the decisionmaking capacity of ICU patients was widely overestimated by all clinicians as compared with a capacity score measured by the Mini-Mental Status Examination and the Aid to Capacity Evaluation.
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Acute Kidney Injury With Combination Antibiotics in the Critically Ill
In this retrospective study, a short course (24 to < 72 hours) of combination antibiotic therapy with piperacillin-tazobactam and vancomycin was not associated with an increased risk of acute kidney injury among critically ill patients when compared with other β-lactam and vancomycin combinations.
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NOACs vs. Warfarin: What Are the Data in Patients With Traumatic Brain Injury and Intracranial Hemorrhage?
A three-year analysis of a prospectively maintained database with traumatic brain injury patients revealed that novel oral anticoagulant use is associated with increased risk of intracranial hemorrhage progression, neurosurgical intervention, and mortality.
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Early Neuromuscular Blockade in Moderate-to-Severe Acute Respiratory Distress Syndrome
When the early use of a continuous infusion of cisatracurium was compared to contemporary supportive care for moderate-to-severe ARDS, including a light sedation target, high positive-end expiratory pressure, and conservative fluid strategy, there was no difference in 90-day mortality. Patients in the early neuromuscular blockade group more frequently experienced a severe cardiovascular event and ICU-acquired weakness by day 28.
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Penetrating Extremity Trauma: Part I
Penetrating extremity trauma is a potentially devastating injury that must be identified and managed expeditiously. Early hemorrhage control may be life-saving. This two-part article comprehensively addresses the approach and management of penetrating extremity trauma, highlighting controversies and advances.
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