Critical Care
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Fecal Transplant vs. Oral Vancomycin Taper for Recurrent Clostridium difficile Infection
In a small randomized, controlled trial that compared fecal microbiota transplant (FMT) administered by enema to a six-week oral vancomycin taper, FMT was not more effective for patients with recurrent Clostridium difficile infection. -
Categorizing Acute Respiratory Distress Syndrome as Direct vs. Indirect Injury
This retrospective observational study compared patients with acute respiratory distress syndrome classified as presenting with direct vs. indirect lung injury and found distinct differences in traditional predictors of hospital mortality between these subgroups.
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Reducing Stress and Anxiety in Mechanically Ventilated, Critically Ill Patients: Does Chaplain-assisted Spiritual Care Play a Role?
In mechanically ventilated, critically ill patients without delirium or dementia, chaplain-led, picture-guided spiritual care is feasible and shows the potential for reducing anxiety and stress during and after an ICU admission.
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A Prospective, Randomized Comparison of Video and Direct Laryngoscopy
In the largest prospective, randomized trial to date, use of video laryngoscopy improved glottic visualization but did not increase procedural success or decrease complications compared to direct laryngoscopy in medical ICU patients.
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Early Initiation of Continuous Renal Replacement Therapy May Reduce Mortality in Patients Who Require Dialysis
Initiation of continuous renal replacement therapy for patients with Kidney Disease: Improving Global Outcomes stage 2 renal failure reduced 90-day all-cause mortality.
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Anticoagulation in the Trauma Patient
The number and variety of anticoagulants have expanded greatly during the past decade. Because of the large number of individuals on anticoagulation for various conditions, anticoagulated patients assuredly will present as trauma patients.
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High-flow Nasal Cannula vs. Noninvasive Ventilation in Postextubation Failure
SYNOPSIS: In this multicenter, randomized, clinical trial of critically ill adults at high risk for reintubation, high-flow conditioned oxygen therapy was not inferior to noninvasive mechanical ventilation with regard to preventing reintubation and postextubation respiratory failure within 72 hours of extubation.
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Diastolic Blood Pressure Goals
SYNOPSIS: An analysis of the community-based ARIC study showed that low diastolic blood pressures were associated with higher baseline and subsequent troponin T levels and adverse cardiac events, but not stroke.
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Pulmonary Embolism Common Cause for Syncope in Hospitalized Patients
Syncope is a chief complaint for which neurologists often are consulted. In most cases, the neurological concern is possible stroke or an epileptic seizure. However, a variety of cardiopulmonary problems are most often the underlying cause of syncope, including cardiac arrhythmias and pulmonary embolism. The investigators of this study reviewed the clinical records of 560 patients (mean age of 76 years) who were admitted to the hospital with syncope.
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New Paradigm in the Management of Massive and Submassive Pulmonary Embolism
SYNOPSIS: A multidisciplinary pulmonary embolism response team is a sustainable option to improve care for severe pulmonary embolism.