Critical Care
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Management of Pulmonary Embolism in the ICU
Small, low-risk pulmonary embolism can be treated as an outpatient procedure or with heparin infusion alone, but higher-risk pulmonary embolism cases are managed properly in an ICU. With the introduction of newer modalities of treatment, appropriate risk stratification and the choice of treatment are increasingly complex.
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Are There Definitive Clues?
How certain are you that the run of wide complex tachycardia that begins with beat #4 is ventricular tachycardia?
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Encephalitis Due to Powassan Virus
Powassan virus is transmitted by the same tick that carries the etiologic agent of Lyme disease and several other pathogens. The number of cases of encephalitis caused by this virus may be increasing in the endemic areas.
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Ready for Dengue in the United States?
Dengue is increasingly recognized in the southern United States. When recently surveyed, however, clinicians in Texas seemed incompletely prepared to understand and manage patients with dengue.
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Infective Endocarditis Trends and Outcomes
Using large databases from New York and California, investigators found the overall incidence of infective endocarditis remained stable between 1998 and 2013, and 90-day mortality declined. Changes were noted in pathogen etiology and patient characteristics over time.
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Assessing Serial Ventilator Settings May Help Reduce Duration of Antibiotic Courses for Suspected Ventilator-associated Pneumonia
In mechanically ventilated patients with stable ventilator settings for at least three days, very short courses of antibiotics (< 3 days) for suspected ventilator-associated pneumonia were associated with similar outcomes when compared to longer courses (> 3 days).
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Prophylactic Steroids Prevent Reintubation in Patients at Risk for Post-extubation Stridor
This meta-analysis demonstrated the administration of steroids between one to 24 hours prior to extubation reduced the risk of reintubation for patients at risk for post-extubation stridor.
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Early Lung Recruitment Reduces Pulmonary Complications
In postoperative cardiac surgery patients with hypoxemia at admission to the ICU, the brief application of an intensive recruitment maneuver followed by lung-protective ventilation was associated with reduced occurrence and severity of pulmonary complications.
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Acute Respiratory Distress Syndrome Treatment Guidelines
This article provides a collaborative, evidence-based guideline for mechanical ventilation in acute respiratory distress syndrome.
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Penetrating Neck Trauma
Penetrating neck trauma presents a clinical challenge to the emergency physician. Clinicians must have a planned approach to these patients to optimize outcomes.