Abstract Traumatic brain injury (TBI) is a common diagnosis requiring acute hospitalization. Long-term, TBI is a significant source of health and socioeconomic impact in the United States and globally. The goal of clinicians who manage TBI is to prevent secondary brain injury. In this population, post-traumatic cerebral infarction (PTCI) acutely after TBI is an important […]
Summary Cardiogenic shock is a complex syndrome defined by systemic hypoperfusion and inadequate cardiac output arising from a wide array of underlying causes. Although the understanding of cardiogenic shock epidemiology, specific subphenotypes, haemodynamics, and cardiogenic shock severity staging has evolved, few therapeutic interventions have shown survival benefit. Results from seminal randomised controlled trials support early
Abstract A personalized mechanical ventilation approach for patients with adult respiratory distress syndrome (ARDS) based on lung physiology and morphology, ARDS etiology, lung imaging, and biological phenotypes may improve ventilation practice and outcome. However, additional research is warranted before personalized mechanical ventilation strategies can be applied at the bedside. Ventilatory parameters should be titrated based
Personalized mechanical ventilation in acute respiratory distress syndrome Read Post »
Abstract The vast majority of injured patients suffer from pain. Systematic assessment of pain on admission to the emergency department (ED) is a cornerstone of translating the best treatment strategies for patient care into practice. Pain must be measured with severity scales that are validated in clinical practice, including for specific populations (such as
The Pain Management of Trauma Patients in the Emergency Department Read Post »
Abstract Background Neonatal encephalopathy (NE) due to suspected hypoxic-ischemic encephalopathy (HIE), referred to as NESHIE, is a clinical diagnosis in late preterm and term newborns. It occurs as a result of impaired cerebral blood flow and oxygen delivery during the peripartum period and is used until other causes of NE have been discounted and HIE
Abstract This review explores the complex interactions between sedation and invasive ventilation and examines the potential of volatile anesthetics for lung- and diaphragm-protective sedation. In the early stages of invasive ventilation, many critically ill patients experience insufficient respiratory drive and effort, leading to compromised diaphragm function. Compared with common intravenous agents, inhaled sedation with volatile anesthetics
Volatile anesthetics for lung- and diaphragm-protective sedation Read Post »
Summary of “Knowing the Ropes of Vasopressor Dosing: A Focus on Norepinephrine” Abstract Summary: This editorial discusses the pharmacological properties, dosing strategies, and clinical considerations for norepinephrine, the first-line vasopressor in managing shock. It highlights the complexities of dosing in critically ill patients, variability in pharmacodynamics, and the need for individualized therapy. The authors emphasize
Knowing the ropes of vasopressor dosing: a focus on norepinephrine Read Post »
Summary of “Practical Assessment of Risk of VILI from Ventilating Power: A Conceptual Model” Abstract Summary: This article introduces a conceptual model for assessing the risk of ventilator-induced lung injury (VILI) based on mechanical power and its components, such as tidal volume, driving pressure (DP), plateau pressure (Ps), and ventilating frequency. By focusing on the
Practical assessment of risk of VILI from ventilating power: a conceptual model Read Post »
Summary of “The Respiratory Mechanics of COVID-19 Acute Respiratory Distress Syndrome—Lessons Learned?” Abstract Summary: The COVID-19 pandemic has expanded our understanding of acute respiratory distress syndrome (ARDS), revealing unique pathophysiological characteristics of COVID-19 ARDS. Distinct features include severe hypoxemia, vascular injury, and microthrombosis, often disproportionate to respiratory compliance. These findings challenge conventional ARDS management strategies,
Summary of “Assessing lung recruitability: does it help with PEEP settings?” This editorial examines the relationship between lung recruitability and the selection of positive end-expiratory pressure (PEEP) settings in acute respiratory distress syndrome (ARDS) management. While recruitability measures the potential to reinflate atelectatic lung regions, PEEP must prevent their collapse while considering additional factors like
Ventilator induced lung injury: a case for a larger umbrella? Read Post »