January 2025

Circulatory, Respiratory

Acute lung injury and post-cardiac arrest syndrome: a narrative review

Abstract Background Post-cardiac arrest syndrome (PCAS) presents a multifaceted challenge in clinical practice, characterized by severe neurological injury and high mortality rates despite advancements in management strategies. One of the important critical aspects of PCAS is post-arrest lung injury (PALI), which significantly contributes to poor outcomes. PALI arises from a complex interplay of pathophysiological mechanisms, […]

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Miscellaneous, Respiratory

Distribution of airway pressure opening in the lungs measured with electrical impedance tomography (POET): a prospective physiological study

Abstract Background In patients with acute hypoxemic respiratory failure (AHRF) under mechanical ventilation, the change in pressure slope during a low-flow insufflation indicates a global airway opening pressure (AOP) needed to reopen closed airways and may be used for titration of positive end-expiratory pressure. Objectives To understand 1) if airways open homogeneously inside the lungs

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Respiratory

High-flow nasal oxygen is the reference treatment in acute hypoxemic respiratory failure: Con

Abstract Over the past decade and boosted by the coronavirus disease 2019 (COVID-19) pandemic, high-flow nasal oxygen (HFNO) has been increasingly used in the intensive care unit (ICU) to treat acute hypoxemic respiratory failure (AHRF). In this review, we show that despite this wide and rapid increase in the use of HFNO to treat AHRF,

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High-flow nasal oxygen is the reference treatment in acute hypoxemic respiratory failure: Con Read Post »

Pharmacological Insights in Critical Care

Pharmacogenetics and the Blood–Brain Barrier: A Whirlwind Tour of Potential Clinical Utility

Abstract Genetic factors influence medication response (pharmacogenetics), affecting the pharmacodynamics and pharmacokinetics of many medicaments used in clinical care. The ability of medications to cross the blood–brain barrier (BBB) represents a critical putative factor in the effectiveness and tolerability of various medications relevant to central nervous system disorders (CNS), cancer, and broader medical conditions at

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Sepsis

Host Response Biomarkers for Sepsis in the Emergency Room

Abstract This review explores the role of host response biomarkers in diagnosing, prognosticating, and managing sepsis in the emergency room (ER). It highlights the benefits of traditional biomarkers like procalcitonin (PCT) and C-reactive protein (CRP) and emerging tools from transcriptomics, proteomics, and metabolomics to improve patient outcomes and advance precision medicine in sepsis care. Key

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Respiratory

Hemodynamic Implications of Prone Positioning in Patients with ARDS

Abstract This review investigates the hemodynamic effects of prone positioning in patients with acute respiratory distress syndrome (ARDS). It highlights how prone positioning influences venous return, right ventricular (RV) and left ventricular (LV) preload, and afterload. Additionally, it evaluates techniques for detecting fluid responsiveness during prone positioning, essential for optimizing fluid therapy and overall patient

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Neurology

Quality improvement in the determination of death by neurologic criteria around the world

Abstract This article discusses global variations in policies and practices for determining death by neurologic criteria (DNC). It highlights efforts to improve standardization and accuracy, emphasizing the importance of adhering to the World Brain Death Project (WBDP) guidelines. The paper also reviews confounders, complications, and special considerations for pediatric patients in DNC determination. Key Points

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Uncategorized

Setting and Monitoring of Mechanical Ventilation During Venovenous ECMO

Abstract This review provides insights into the management of mechanical ventilation during venovenous extracorporeal membrane oxygenation (VV-ECMO) for severe acute respiratory distress syndrome (ARDS). It focuses on strategies to minimize ventilator-induced lung injury (VILI) by employing ultra-lung-protective ventilation, exploring key parameters like tidal volume, plateau pressure, and driving pressure. Key Points Lung Rest Strategy: VV-ECMO

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Circulatory

Management of Hemorrhagic Shock: Physiology Approach, Timing and Strategies

Abstract Hemorrhagic shock (HS) management is based on a timely, rapid, definitive source control of bleeding/s and on blood loss replacement. Stopping the hemorrhage from progressing from any named and visible vessel is the main stem fundamental praxis of efficacy and effectiveness and an essential, obligatory, life-saving step. Blood loss replacement serves the purpose of

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Sepsis

Advances and Challenges in Sepsis Management: Modern Tools and Future Directions

Abstract Sepsis, a critical condition marked by systemic inflammation, profoundly impacts both innate and adaptive immunity, often resulting in lymphopenia. This immune alteration can spare regulatory T cells (Tregs) but significantly affects other lymphocyte subsets, leading to diminished effector functions, altered cytokine profiles, and metabolic changes. The complexity of sepsis stems not only from its

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