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In this prospective study carried out in a 13-bed French medical ICU, Thille and associates sought to determine the clinical characteristics and outcomes of patients who experienced extubation failure the requirement for reintubation within 72 hours of either planned or unplanned extubation.
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In Part 1 of this two-part series on Pregnancy and Critical Care Medicine (see Critical Care Alert, March 2011, p. 89-93), we reviewed the normal physiologic changes that occur during pregnancy, examining changes occurring across multiple organ systems that affect our management of these patients as well as the ability of the pregnant woman to respond to various forms of stress, such as acute hemorrhage.
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In this issue: Apixaban could soon join the anticoagulation market; Chinese herbs for flu; chronic medication and discontinuation after hospitalization; and FDA actions.
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Clinical depression is highly prevalent in the general population and in primary care settings. Although clinicians presently have a broad array of pharmacological agents for the treatment of depression, including selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors, overall response rates and remission rates with these pharmacological agents remain relatively modest.
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The authors advocate that cardiovascular magnetic resonance imaging using specific criteria may be useful as a diagnostic tool for patients with stress cardiomyopathy at the time of acute clinical presentation.
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In the ICUs of a well-staffed academic medical center committed to quality improvement, in which closed staffing, multidisciplinary rounds, and the daily use of checklists were already in place, implementation of a 24-hour ICU telemedicine system that was well accepted by the medical staff was associated with impressive improvements in adherence to best practice standards as well as with reductions in hospital mortality and lengths of stay.
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Add Tdap to the growing list of recommended (and often required) vaccinations for health care workers (HCWs) in hospital, including MMR, hepatitis B, influenza, and possibly varicella. In April, the American College of Immunization Practices (ACIP) issued provisional recommendations for pertussis vaccination (Tdap) of all hospital HCWs, regardless of age and prior vaccine history (i.e., regardless of the time since last Td dose).