Critical Care
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Management Guidelines for Acute Pancreatitis
There are more than 275,000 hospitalizations for acute pancreatitis per year, with more than $2.6 billion spent on care worldwide. Many of these cases require ICU admission. Mortality rates vary between 2% and 17% depending on illness severity. Despite this burden of illness, questions remain regarding the most basic elements of care.
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Saline vs. Balanced Crystalloids in Critically Ill Adults
Balanced crystalloids appear to reduce in-hospital mortality in critically ill patients with sepsis or without traumatic brain injury and may reduce in-hospital mortality in the entire cohort of critically ill patients.
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Presepsis Pathways: Can We Predict Mortality After Sepsis Hospitalization?
Using a latent profile analysis in observational cohort studies of patients hospitalized for sepsis, investigators identified subtypes of patients based on inpatient healthcare facility use in the year prior to sepsis hospitalization and correlated to 90-day mortality.
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Ventilator-Associated Pneumonia and Hospital-Acquired Pneumonia: Prevention and Treatment
Ventilator-assisted pneumonia and hospital-acquired pneumonia pose significant risks to hospitalized patients and increase the cost of care. It is essential to institute measures to reduce the risk of these pneumonias and to recognize and treat them early when they occur. Treatment is a balance of ensuring adequate antimicrobial coverage in those who already are seriously ill while not unduly exposing them to the risks of medication side effects and higher rates of resistant organisms that come with the use of broad-spectrum antibiotics.
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Blunt Pelvic Trauma
The management of pelvic trauma has evolved significantly in the last 20 years, with advances in devices and procedures. The key to success is having a team of physicians, including specialists in emergency medicine, interventional radiology, and surgery, who can work together to provide each patient the best outcome possible.
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Corticosteroid Administration in Sepsis May Be Associated With Lower 28-Day Mortality
In this systematic review and meta-analysis of randomized, controlled trials comparing administration of corticosteroids with placebo or standard supportive care in sepsis, corticosteroids were associated with reduced 28-day mortality.
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Using Ketamine in the Critically Ill: A Clinical Review
This is a guideline for ketamine use in the appropriate clinical setting from the practicing intensivist’s perspective.
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Rethinking the Prophylactic Use of Proton Pump Inhibitors in the ICU
The authors of this multicenter, blinded, randomized trial found that among critically ill adults at risk for gastrointestinal (GI) bleeding, fewer patients in the pantoprazole group exhibited clinically important GI bleeding compared to placebo, although mortality at 90 days was similar in both groups.
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Late Awakening Among Cardiac Arrest Survivors Predicts Worse Short- and Long-Term Outcomes
In this retrospective single-center study, late awakening after cardiac arrest was associated with a higher rate of unfavorable outcomes immediately after awakening and at three months.
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Mechanical Circulatory Support for Cardiogenic Shock
Exploring what options exist for temporary percutaneous mechanical support for cardiogenic shock associated with acute myocardial infarction?