journal
https://read.qxmd.com/read/38525881/antimicrobial-stewardship-and-molecular-diagnostics-a-symbiotic-approach-to-combating-resistance-in-the-ed-and-icu
#1
JOURNAL ARTICLE
Jan J De Waele, Jerina Boelens
PURPOSE OF THE REVIEW: This review aims to evaluate the incorporation of rapid molecular diagnostics (RMD) in antimicrobial stewardship programs (ASPs) in the management of patients in the emergency department (ED) and intensive care unit (ICU), highlighting a shift from conventional microbiological diagnostic tests to RMD strategies to optimize antimicrobial use and improve patient outcomes. RECENT FINDINGS: Recent advances in RMD have demonstrated the superior accuracy of RMD in identifying pathogens, combined with shorter turnaround times...
March 22, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38525875/boarding-in-the-emergency-department-challenges-and-mitigation-strategies
#2
JOURNAL ARTICLE
Fernando J da Silva Ramos, Flavio G R Freitas, Flavia R Machado
PURPOSE OF REVIEW: Herein, we conducted a review of the literature to better understand the issue of prolonged emergency department (ED) boarding by providing an overview of the current evidence on the available causes, consequences, and mitigation strategies. RECENT FINDINGS: Severely ill patients awaiting transfer to intensive care units (ICU) imposes additional burdens on the emergency care team from both a clinical and management perspective. The reasons for prolonged ED boarding are multifactorial...
March 20, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38525882/artificial-intelligence-to-advance-acute-and-intensive-care-medicine
#3
JOURNAL ARTICLE
Laurens A Biesheuvel, Dave A Dongelmans, Paul W G Elbers
PURPOSE OF REVIEW: This review explores recent key advancements in artificial intelligence for acute and intensive care medicine. As artificial intelligence rapidly evolves, this review aims to elucidate its current applications, future possibilities, and the vital challenges that are associated with its integration into emergency medical dispatch, triage, medical consultation and ICUs. RECENT FINDINGS: The integration of artificial intelligence in emergency medical dispatch (EMD) facilitates swift and accurate assessment...
March 14, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441088/critical-illness-associated-limb-and-diaphragmatic-weakness
#4
JOURNAL ARTICLE
Valentine Le Stang, Nicola Latronico, Martin Dres, Michele Bertoni
PURPOSE OF REVIEW: In the current review, we aim to highlight the evolving evidence on the diagnosis, prevention and treatment of critical illness weakness (CIW) and critical illness associated diaphragmatic weakness (CIDW). RECENT FINDINGS: In the ICU, several risk factors can lead to CIW and CIDW. Recent evidence suggests that they have different pathophysiological mechanisms and impact on outcomes, although they share common risk factors and may overlap in several patients...
March 5, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441108/effective-approaches-to-address-noncompressible-torso-hemorrhage
#5
JOURNAL ARTICLE
Marc Maegele
PURPOSE OF THE REVIEW: Noncompressible torso hemorrhage (NCTH) is now considered as the major cause of preventable death after both severe military and civilian trauma. Around 20% of all trauma patients still die from uncontrolled exsanguination along with rapidly evolving hemostatic failure. This review highlights the most recent advances in the field and provides an outline for future research directions. RECENT FINDINGS: The updated definition of NCTH includes a combination of high-grade anatomical torso injury, hemodynamic instability, urgent need for hemorrhage control and aggressive hemostatic resuscitation...
February 29, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441073/how-to-manage-catatonia-parkinson-and-dementia-in-icu
#6
JOURNAL ARTICLE
David Attali, Charlotte Calligaris, David Grabli, Arjen J C Slooter
PURPOSE OF REVIEW: The rising prevalence of neurodegenerative and mental disorders, combined with the challenges posed by their frailty, has presented intensivists with complex issues in the intensive care unit (ICU). This review article explores specific aspects of care for patients with catatonia, Parkinson's disease (PD), and dementia within the context of the ICU, shedding light on recent developments in these fields. RECENT FINDINGS: Catatonia, a neuropsychiatric syndrome with potentially life-threatening forms, remains underdiagnosed, and its etiologies are diverse...
February 27, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441086/challenges-with-medical-tourism
#7
JOURNAL ARTICLE
Helena C Maltezou, Androula Pavli
PURPOSE OF REVIEW: With the return of international travels to almost prepandemic levels, the number of patients who travel abroad to seek healthcare services is once again growing rapidly. Nevertheless, the expected benefits of medical tourism may be challenged by serious infectious complications. This review summarizes the evolving published evidence on infectious complications related with medical tourism of the last eighteen months. RECENT FINDINGS: There has been an increase of reported infectious complications in patients who had received healthcare abroad...
February 26, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441162/status-epilepticus-what-s-new-for-the-intensivist
#8
JOURNAL ARTICLE
Sarah Benghanem, Estelle Pruvost Robieux, Aidan Neligan, Matthew C Walker
PURPOSE OF REVIEW: Status epilepticus (SE) is a common neurologic emergency affecting about 36.1/100 000 person-years that frequently requires intensive care unit (ICU) admission. There have been advances in our understanding of epidemiology, pathophysiology, and EEG monitoring of SE, and there have been large-scale treatment trials, discussed in this review. RECENT FINDINGS: Recent changes in the definitions of SE have helped guide management protocols and we have much better predictors of outcome...
February 14, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441156/acute-encephalopathy-in-the-icu-a-practical-approach
#9
JOURNAL ARTICLE
Pedro Kurtz, Mark van den Boogaard, Timothy D Girard, Bertrand Hermann
PURPOSE OF REVIEW: Acute encephalopathy (AE) - which frequently develops in critically ill patients with and without primary brain injury - is defined as an acute process that evolves rapidly and leads to changes in baseline cognitive status, ranging from delirium to coma. The diagnosis, monitoring, and management of AE is challenging. Here, we discuss advances in definitions, diagnostic approaches, therapeutic options, and implications to outcomes of the clinical spectrum of AE in ICU patients without primary brain injury...
February 12, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441114/autoimmune-and-inflammatory-neurological-disorders-in-the-intensive-care-unit
#10
JOURNAL ARTICLE
Camille Legouy, Anna Cervantes, Romain Sonneville, Kiran T Thakur
PURPOSE OF REVIEW: The present review summarizes the diagnostic approach to autoimmune encephalitis (AE) in the intensive care unit (ICU) and provides practical guidance on therapeutic management. RECENT FINDINGS: Autoimmune encephalitis represents a group of immune-mediated brain diseases associated with antibodies that are pathogenic against central nervous system proteins. Recent findings suggests that the diagnosis of AE requires a multidisciplinary approach including appropriate recognition of common clinical syndromes, brain imaging and electroencephalography to confirm focal pathology, and cerebrospinal fluid and serum tests to rule out common brain infections, and to detect autoantibodies...
February 12, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441121/neuromonitoring-in-the-icu-what-how-and-why
#11
JOURNAL ARTICLE
Rohan Mathur, Geert Mefroidt, Chiara Robba, Robert D Stevens
PURPOSE OF REVIEW: We selectively review emerging noninvasive neuromonitoring techniques and the evidence that supports their use in the ICU setting. The focus is on neuromonitoring research in patients with acute brain injury. RECENT FINDINGS: Noninvasive intracranial pressure evaluation with optic nerve sheath diameter measurements, transcranial Doppler waveform analysis, or skull mechanical extensometer waveform recordings have potential safety and resource-intensity advantages when compared to standard invasive monitors, however each of these techniques has limitations...
February 8, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441127/what-s-new-in-whole-blood-resuscitation-in-the-trauma-bay-and-beyond
#12
JOURNAL ARTICLE
Stacy L Coulthard, Lewis J Kaplan, Jeremy W Cannon
PURPOSE OF REVIEW: Transfusion therapy commonly supports patient care during life-threatening injury and critical illness. Herein we examine the recent resurgence of whole blood (WB) resuscitation for patients in hemorrhagic shock following trauma and other causes of severe bleeding. RECENT FINDINGS: A growing body of literature supports the use of various forms of WB for hemostatic resuscitation in military and civilian trauma practice. Different types of WB include warm fresh whole blood (FWB) principally used in the military and low titer O cold stored whole blood (LTOWB) used in a variety of military and civilian settings...
February 7, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441124/enteral-nutrition-in-septic-shock-a-call-for-a-paradigm-shift
#13
JOURNAL ARTICLE
Jayshil J Patel, Juan Carlos Lopez-Delgado, Christian Stoppe, Stephen A McClave
PURPOSE OF REVIEW: The purpose of this review is to identify contemporary evidence evaluating enteral nutrition in patients with septic shock, outline risk factors for enteral feeding intolerance (EFI), describe the conundrum of initiating enteral nutrition in patients with septic shock, appraise current EFI definitions, and identify bedside monitors for guiding enteral nutrition therapy. RECENT FINDINGS: The NUTRIREA-2 and NUTRIREA-3 trial results have better informed the dose of enteral nutrition in critically ill patients with circulatory shock...
January 15, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441190/micronutrients-as-therapy-in-critical-illness
#14
JOURNAL ARTICLE
Christian Stoppe, Ellen Dresen, Angelique de Man
PURPOSE OF REVIEW: Recent large-scale randomized controlled trials (RCTs) challenged current beliefs about the potential role of micronutrients to attenuate the inflammatory response and improve clinical outcomes of critically ill patients. The purpose of this narrative review is to provide an overview and critical discussion about most recent clinical trials, which evaluated the clinical significance of a vitamin C, vitamin D, or selenium administration in critically ill patients. RECENT FINDINGS: None of the most recent large-scale RCTs could demonstrate any clinical benefits for a micronutrient administration in ICU patients, whereas a recent RCT indicated harmful effects, if high dose vitamin C was administered in septic patients...
January 8, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38465969/editorial-the-neurologist-s-guide-to-the-icu-galaxy
#15
JOURNAL ARTICLE
Tarek Sharshar
No abstract text is available yet for this article.
April 1, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441138/current-fistula-management
#16
REVIEW
Erin Vanzant, Ashley Thompson, April Mendoza, Dante Yeh
PURPOSE OF REVIEW: Enterocutaneous fistulas (ECFs) pose a significant impact in the healthcare system, both financially and in resource utilization. Delivery of optimal care is complex and involves intensive wound care, complex nutritional delivery and multidisciplinary care teams for optimization. Recently, there have been pushes to modernize the traditional approach to ECF care to a new paradigm of protocol-based individualized delivery of care. RECENT FINDINGS: There is an increased trend towards pushing enteral nutrition for the management of ECF patients...
April 1, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441134/anticipating-icu-discharge-and-long-term-follow-up
#17
JOURNAL ARTICLE
Regis Goulart Rosa, Cassiano Teixeira, Simone Piva, Alessandro Morandi
PURPOSE OF REVIEW: This review aims to summarize recent literature findings on long-term outcomes following critical illness and to highlight potential strategies for preventing and managing health deterioration in survivors of critical care. RECENT FINDINGS: A substantial number of critical care survivors experience new or exacerbated impairments in their physical, cognitive or mental health, commonly named as postintensive care syndrome (PICS). Furthermore, those who survive critical illness often face an elevated risk of adverse outcomes in the months following their hospital stay, including infections, cardiovascular events, rehospitalizations and increased mortality...
April 1, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441116/measurement-and-estimation-of-energy-in-the-critically-ill
#18
REVIEW
Amir Y Kamel
PURPOSE OF REVIEW: Recent changes in guidelines recommendation during early phase of critical illness and use of indirect calorimetry. The aim of this review is to discuss methods of determining energy requirements in the critically ill and highlight factors impacting resting energy expenditure. RECENT FINDING: An appraisal of recent literature discussing indirect calorimetry guided-nutrition potential benefits or pitfalls. Recent attempts to devise strategy and pilot indirect calorimetry use in the critically ill patients requiring continuous renal replacement therapy or extracorporeal membrane oxygenation are also discussed...
April 1, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38164972/peep-setting-let-us-come-back-to-physiology
#19
JOURNAL ARTICLE
Lise Piquilloud
No abstract text is available yet for this article.
February 1, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38085886/hemodynamic-effects-of-positive-end-expiratory-pressure
#20
REVIEW
Adrien Joseph, Matthieu Petit, Antoine Vieillard-Baron
PURPOSE OF REVIEW: Positive end-expiratory pressure (PEEP) is required in the Berlin definition of acute respiratory distress syndrome and is a cornerstone of its treatment. Application of PEEP increases airway pressure and modifies pleural and transpulmonary pressures according to respiratory mechanics, resulting in blood volume alteration into the pulmonary circulation. This can in turn affect right ventricular preload, afterload and function. At the opposite, PEEP may improve left ventricular function, providing no deleterious effect occurs on the right ventricle...
February 1, 2024: Current Opinion in Critical Care
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