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Mechanical Ventilation

Effect of Automated Closed-loop ventilation versus conventional Ventilation on duration and quality of ventilation in critically ill patients (ACTiVE)

Abstract The MVENT trial is a multicentre, assessor-blinded, parallel-group pilot RCT designed to compare a “minimal ventilation” strategy—daily one-hour spontaneous breathing trials (SBT) with minimal pressure support or CPAP—versus usual care in critically ill adults mechanically ventilated for ≥24 hours. The hypothesis is that minimal support SBTs may better assess readiness for extubation, avoid over-assistance, […]

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Effect of Automated Closed-loop ventilation versus conventional Ventilation on duration and quality of ventilation in critically ill patients (ACTiVE) Read Post »

Circulatory

Mixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions

Abstract This state-of-the-art review defines mixed cardiogenic–vasodilatory shock as overt hypotension with end-organ hypoperfusion arising from the combination of acute cardiac insufficiency (low cardiac output) and inappropriate systemic vasodilation, typically with normal or elevated filling pressures; it introduces a pragmatic three-group classification (cardiogenic-vasodilatory, vasodilatory-cardiogenic, and primary mixed shock), emphasizes invasive hemodynamic monitoring, and outlines management

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Mixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions Read Post »

Miscellaneous

Consensus recommendations for the integration of critical care pharmacists on intensive care unit teams: Endorsed by the American Association of……

Summary This article presents consensus recommendations developed to optimize the integration of critical care pharmacists (CCPs) within multidisciplinary intensive care unit (ICU) teams. Recognizing the proven benefits of CCPs, including improved patient outcomes and enhanced medication safety, the recommendations focus on standards, infrastructure, and best practices for implementing CCPs effectively. Developed using a modified Delphi

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Consensus recommendations for the integration of critical care pharmacists on intensive care unit teams: Endorsed by the American Association of…… Read Post »

Sepsis

Source control in bloodstream infections in patients with sepsis, septic shock, or requiring ICU admission: a scoping review with recommendations…..

Summary This scoping review examines source control (SC) in bloodstream infections (BSI) among critically ill patients with sepsis, septic shock, or intensive care unit (ICU) admission, highlighting the substantial variability in definitions, interventions, timing, and adequacy reporting. The review analyzed 77 studies, finding significant methodological inconsistencies and an overrepresentation of catheter-related infections and candidemia. It

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Source control in bloodstream infections in patients with sepsis, septic shock, or requiring ICU admission: a scoping review with recommendations….. Read Post »

Miscellaneous

Choosing wisely: who really benefits from critical care EEG monitoring?

Summary This commentary explores the clinical utility and challenges associated with critical care continuous electroencephalogram (cEEG) monitoring, particularly focusing on critically ill patients experiencing seizures and status epilepticus. The authors examine recent evidence suggesting limited differences in outcomes between cEEG and routine EEG approaches, highlighting uncertainties around whether seizures observed in critical illness independently contribute

Choosing wisely: who really benefits from critical care EEG monitoring? Read Post »

Respiratory

Ventilator-associated pneumonia: mechanisms, an appraisal of current therapies and the role for inhaled antibiotics in prevention and treatment

Summary Ventilator-associated pneumonia (VAP), the most common healthcare-associated infection in the ICU, significantly increases healthcare costs and negatively impacts patient outcomes. The review outlines complex VAP pathophysiology, involving abnormal microbiota colonization and micro-aspiration associated with mechanical ventilation. Traditional intravenous antibiotic therapies face challenges such as systemic complications and antibiotic resistance, while inhaled antibiotics offer a

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Ventilator-associated pneumonia: mechanisms, an appraisal of current therapies and the role for inhaled antibiotics in prevention and treatment Read Post »

Mechanical Ventilation

Individualized Lung-Protective Ventilation Strategy Based on Esophageal Pressure Monitoring in Patients With ARDS Associated With Severe Acute….

Summary This randomized controlled trial investigated the effectiveness of an individualized lung-protective ventilation strategy guided by esophageal pressure (Pes) monitoring compared to conventional ventilation in patients with acute respiratory distress syndrome (ARDS) secondary to severe acute pancreatitis (SAP). The individualized Pes-guided strategy significantly improved respiratory mechanics, oxygenation, and clinical outcomes, demonstrating reduced transpulmonary driving pressure,

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Individualized Lung-Protective Ventilation Strategy Based on Esophageal Pressure Monitoring in Patients With ARDS Associated With Severe Acute…. Read Post »

Cardiovascular

Prognostic implication of venoarterial extracorporeal membrane oxygenation in acute myocardial infarction-related cardiogenic shock

Summary This retrospective study aimed to evaluate clinical outcomes in patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock (CS), comparing acute myocardial infarction-related cardiogenic shock (AMI-CS) with non-AMI-CS. Analysis of data from 667 patients treated between 2008 and 2023 showed that AMI-CS was associated with significantly lower in-hospital mortality compared to non-AMI-CS. Independent

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Prognostic implication of venoarterial extracorporeal membrane oxygenation in acute myocardial infarction-related cardiogenic shock Read Post »

Cardiovascular

The role of serial point-of-care ultrasound during cardiac arrest to predict termination of resuscitation

Summary This prospective cohort study evaluated the utility of serial point-of-care ultrasound (POCUS) during cardiopulmonary resuscitation (CPR) to determine optimal timing for terminating resuscitation efforts in patients presenting with non-shockable cardiac arrest rhythms. Conducted in two academic hospitals, serial ultrasounds every two minutes were used to measure cardiac standstill duration and predict return of spontaneous

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The role of serial point-of-care ultrasound during cardiac arrest to predict termination of resuscitation Read Post »

Respiratory

Echocardiography in the Ventilated Patient: What the Clinician Has to Know

Summary This review discusses echocardiographic evaluation in mechanically ventilated (MV) patients, highlighting the complex heart–lung interactions influenced by positive pressure ventilation, especially focusing on the right ventricle (RV). Echocardiography serves as a crucial bedside tool to assess RV dimensions, function, and response to mechanical ventilation. Given the challenges in assessing fluid responsiveness and diaphragmatic function

Echocardiography in the Ventilated Patient: What the Clinician Has to Know Read Post »

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