Paul E Marik, Rodrigo Cavallazzi
BACKGROUND: Despite a previous meta-analysis that concluded that central venous pressure should not be used to make clinical decisions regarding fluid management, central venous pressure continues to be recommended for this purpose. AIM: To perform an updated meta-analysis incorporating recent studies that investigated indices predictive of fluid responsiveness. A priori subgroup analysis was planned according to the location where the study was performed (ICU or operating room)...
July 2013: Critical Care Medicine
Beverley J Hunt
No abstract text is available yet for this article.
February 27, 2014: New England Journal of Medicine
Anthony J Weekes, David A Johnson, Stephen M Keller, Bradley Efune, Christopher Carey, Nigel L Rozario, H James Norton
OBJECTIVES: Central venous catheter (CVC) placement is a common procedure in critical care management. The authors set out to determine echocardiographic features during a saline flush of any type of CVC. The hypothesis was that the presence of a rapid saline swirl in the right atrium on bedside echocardiography would confirm correct placement of the CVC tip, similar to the accuracy of the postplacement chest radiograph (CXR). METHODS: This was a prospective convenience sample of emergency department (ED) and intensive care unit (ICU) patients who had CVCs placed...
January 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Oguz Kilickaya, Ognjen Gajic
The lung-protective mechanical ventilation strategy has been standard practice for management of acute respiratory distress syndrome (ARDS) for more than a decade. Observational data, small randomized studies and two recent systematic reviews suggest that lung protective ventilation is both safe and potentially beneficial in patients who do not have ARDS at the onset of mechanical ventilation. Principles of lung-protective ventilation include: a) prevention of volutrauma (tidal volume 4 to 8 ml/kg predicted body weight with plateau pressure<30 cmH2O); b) prevention of atelectasis (positive end-expiratory pressure‚Č•5 cmH2O, as needed recruitment maneuvers); c) adequate ventilation (respiratory rate 20 to 35 breaths per minute); and d) prevention of hyperoxia (titrate inspired oxygen concentration to peripheral oxygen saturation (SpO2) levels of 88 to 95%)...
March 12, 2013: Critical Care: the Official Journal of the Critical Care Forum
Scott D Weingart, Robert L Sherwin, Lillian L Emlet, Isaac Tawil, Julie Mayglothling, Jon C Rittenberger
No abstract text is available yet for this article.
March 2013: American Journal of Emergency Medicine
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