Critical Care
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Emerging Treatment for Refractory Vasodilatory Shock
Shock is a common cause for intensive care unit admission, necessitating rapid treatment of the underlying cause while supporting patients with fluids and vasopressor agents. Typical vasopressor agents include adrenergic agonists and vasopressin. When shock persists despite these interventions, this is labeled refractory shock.
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ICU Admission Means Trouble for Alzheimer's and Dementia Patients
If they are released, such patients are twice as likely to die soon after discharge.
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Ethicists Hold Debriefings After Critical Patient Events
In the emotionally charged, fast-paced ICU, clinicians are faced with death and dying daily. Engaging in open, honest communication about these situations will help build a moral and ethical community.
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ICU Staff Report Severe Moral Distress, But Resources Are Underused
Unresolved ethical concerns not only cause individual moral distress, but can also change the staff relationships and clinical cohesiveness.
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Ethical Guidance for Research on Dying or Recently Deceased ICU Patients
There are no authoritative international ethical guidelines governing research on dying or recently deceased individuals. A group of investigators sought to start a conversation about challenges and potential solutions. They developed a preliminary framework for the ethical conduct of research with imminently dying patients.
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Progress on Pediatric Readiness in EDs Continues
The pandemic slowed progress and not all emergency departments fully adhere to national guidelines, but continuous improvement is evident.
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Patient Mortality Not Linked to Intensivist Caseloads
In this retrospective cohort study in the United States from 2018-2020, there was no significant association between intensivist-to-patient ratio and patient mortality and no effect modification by having physicians-in-training, nurse practitioners, and physician assistants present.
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Effectiveness of Aerosolized Bronchodilators in Patients Receiving High-Flow Nasal Cannula Oxygen Therapy
In a prospective, single-center study, bronchodilators delivered in line with a high-flow nasal cannula device improved forced expiratory volume in one second and forced vital capacity in patients with chronic obstructive pulmonary disease exacerbation.
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Older ICU Survivors Often Receive New and Persistent Prescriptions for Sedatives After Discharge
In this population-based cohort study of older intensive care unit survivors, one in 15 of them received a new prescription for a sedative within a week of discharge, and more than half had recurrent prescriptions.
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Videolaryngoscopy for Intubation of Critically Ill Patients
In a large, prospective, multicenter, randomized, pragmatic trial, the use of a video laryngoscope resulted in a higher incidence of successful intubation on the first attempt on critically ill patients in the emergency department and intensive care unit compared to the use of the direct laryngoscope.