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Rheumatologic and autoimmune disease patients often present with very complex manifestations that can be confusing and challenging to accurately diagnose. Clinicians increasingly depend on both common and arcane laboratory testing to facilitate arriving at a confident final diagnosis, even though most diagnoses are made through thorough history taking and careful physical examination.
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Evidence-based updates in primary care medicine By Louis Kuritzky, MD
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In mechanically ventilated ICU patients, availability of music via headphones resulted in a greater reduction in anxiety and sedation exposure.
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In this study, closed-loop, titrated pressure support ventilation was associated with a significantly shorter time course until patients passed a spontaneous breathing trial and were successfully extubated compared to a standardized weaning protocol.
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This large, multicenter, quality improvement project showed a dramatic reduction in mortality among patients with severe sepsis or septic shock after implementation of a sepsis treatment bundle.
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This was a comprehensive, interdisciplinary, 2-year quality improvement project to reduce continuous sedation infusions and improve the recognition and prevention of delirium in patients with acute lung injury. It resulted in less infusion use, more days per patient without sedation, and more patient days awake and not delirious, although the median proportion of days with delirium per patient actually increased.
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n their 1985 article The Chronically Critically Ill: To Save or Let Die?, Girard and Raffin created the term chronically critically ill to describe patients admitted to an ICU who survived their acute insults but remained dependent on intensive care therapies.
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This multicenter, randomized controlled trial compared daily B-type natriuretic peptide (BNP) measurements as a way to guide fluid management with usual care in patients undergoing weaning from mechanical ventilation.
