Cardiovascular

Cardiovascular, Respiratory

Awake vs. Sedated Cannulation for Extra-Corporeal Membrane Oxygenation in Patients with COVID-19 Induced Acute Respiratory Distress Syndrome

Why this article matters   Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is routinely initiated in patients with severe ARDS after intubation, deep sedation, and often neuromuscular blockade. During the COVID-19 pandemic, however, some centers explored an alternative strategy: awake ECMO cannulation, in which patients are cannulated while spontaneously breathing and supported without invasive mechanical ventilation. The […]

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Cardiovascular

Advances in resuscitation and deresuscitation

Summary This review discusses significant recent developments in fluid resuscitation and deresuscitation practices within critical care, highlighting a paradigm shift toward conservative, personalized fluid management. Advances in fluid stewardship, goal-directed fluid therapy (GDFT), and innovative monitoring tools, including automated closed-loop systems and machine learning, support a precision medicine approach. The authors advocate for balanced resuscitation

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Cardiovascular

Cardiogenic shock syndrome unraveled: understanding the different layers of heterogeneity

Summary Cardiogenic shock (CS) represents a heterogeneous clinical syndrome characterized by sustained tissue hypoperfusion due to cardiac dysfunction, encompassing diverse etiological, hemodynamic, and molecular profiles. The paper emphasizes the need for recognizing CS heterogeneity through clinical classification, ventriculo-arterial coupling, macro- and microcirculatory considerations, and molecular subphenotyping. These multiple layers of complexity suggest that personalized medicine

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Cardiovascular, Circulatory

Does targeted temperature management at 33 °C improve outcome after cardiac arrest?

Summary The article explores targeted temperature management (TTM) at 33°C as a treatment for patients following cardiac arrest, presenting arguments both in favor and against its use. TTM has been extensively debated due to conflicting clinical trial outcomes, variability in evidence from systematic reviews, and differences in interpretation of clinical utility. This review critically assesses

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Does targeted temperature management at 33 °C improve outcome after cardiac arrest? Read Post »

Cardiovascular

Management of cardiogenic shock: state-of-the-art

Abstract: Jung et al. provide a comprehensive review addressing current knowledge and contemporary practices in the management of cardiogenic shock (CS). Despite advancements, mortality remains high, and the complexity of patient care underscores the need for individualized treatments. The authors highlight recent evidence in pharmacological therapies, mechanical circulatory support (MCS), and the potential for personalized

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Cardiovascular

Intraoperative extracorporeal support for lung transplant: a systematic review and network meta-analysis

Abstract: Pettenuzzo et al. conducted a systematic review and network meta-analysis evaluating the efficacy and safety of intraoperative extracorporeal supports—veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and cardiopulmonary bypass (CPB)—compared to off-pump strategies during lung transplantation (LT). Their analysis revealed that off-pump approaches generally offered better outcomes, while V-A ECMO, particularly as a default strategy, showed

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Cardiovascular

Fluid balance and outcome in cardiac arrest patients admitted to intensive care unit

Summary Renaudier et al. conducted a multicenter study to evaluate the impact of fluid balance on outcomes in patients admitted to intensive care units (ICUs) after out-of-hospital cardiac arrest (OHCA). The study found that a positive fluid balance was consistently associated with increased mortality, highlighting potential benefits of restrictive fluid management in this patient group.

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Cardiovascular

Navigating Hemorrhagic Shock: Biomarkers, Therapies, and Challenges in Clinical Care

Summary Hemorrhagic shock remains a leading cause of preventable death globally, characterized by a complex, time-sensitive inflammatory response that evolves from hyperinflammation to immunosuppression. This review explores the pathophysiology, progression, and systemic consequences of hemorrhagic shock, emphasizing the interplay between tissue injury, endothelial dysfunction, coagulopathy, and metabolic derangements. The article outlines established and emerging biomarkers,

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Cardiovascular, Pulmonary

Right Ventricular Function in ARDS: Impact on Outcome, Respiratory Strategy and Use of VV-ECMO

Summary of Right Ventricular Function in Acute Respiratory Distress Syndrome: Impact on Outcome, Respiratory Strategy and Use of Veno-Venous Extracorporeal Membrane Oxygenation Abstract Summary: Petit et al. explore the pathophysiology of right ventricular (RV) dysfunction in Acute Respiratory Distress Syndrome (ARDS), emphasizing its significant impact on patient outcomes. The authors propose an RV-protective management strategy

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Right Ventricular Function in ARDS: Impact on Outcome, Respiratory Strategy and Use of VV-ECMO Read Post »

Cardiovascular, Pulmonary

Navigating Heart–Lung Interactions in Mechanical Ventilation: Pathophysiology, Diagnosis, and Advanced Management Strategies in ARDS and Beyond

Summary of “Navigating Heart–Lung Interactions in Mechanical Ventilation: Pathophysiology, Diagnosis, and Advanced Management Strategies in Acute Respiratory Distress Syndrome and Beyond” Abstract: This article explores the intricate cardiopulmonary dynamics encountered in critically ill patients undergoing mechanical ventilation. It emphasizes the importance of understanding heart–lung interactions, particularly the vulnerability of the right ventricle (RV) under mechanical

Navigating Heart–Lung Interactions in Mechanical Ventilation: Pathophysiology, Diagnosis, and Advanced Management Strategies in ARDS and Beyond Read Post »

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