Miscellaneous

Miscellaneous, Uncategorized

Demystifying Volume Status

Summary Accurate evaluation of patient volume status is crucial yet challenging, impacting critical decisions on fluid management and vasoactive therapies. Traditional clinical methods often lack precision due to complexities in fluid distribution and homeostasis. This review provides a structured physiologic framework leveraging point-of-care ultrasound (POCUS) to assess volume status comprehensively. It emphasizes integrating central venous […]

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Circulatory, Miscellaneous

Measurement and interpretation of central venous pressure: a narrative review

Summary This narrative review explores the historical development, physiological underpinnings, measurement techniques, and clinical relevance of central venous pressure (CVP) in perioperative and critical care settings. Although traditionally used as a marker for fluid responsiveness and intravascular volume status, evidence now emphasizes that CVP alone is unreliable for guiding fluid therapy. Nonetheless, when used alongside

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Miscellaneous

How we use ultrasound to support clinical decisions on fluid administration in critical ill patients

🩺 How Ultrasound Guides Fluid Administration in Critical Illness Abstract: Intravenous fluids are among the most frequently used therapies in critical care but must be considered drugs, carrying both benefits and risks. Critical care ultrasound (CCUS)—through echocardiography (CCE), lung ultrasound (LUS), and venous excess ultrasound (VExUS)—offers a structured way to assess the risks and benefits

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Miscellaneous

Acid–Base Status in Critically Ill Patients: Physicochemical vs. Traditional Approach

Summary Ciabattoni et al. conducted a prospective observational study to evaluate the prevalence and progression of acid–base disturbances in mechanically ventilated ICU patients using traditional (standard base excess—SBE) and physicochemical (Stewart method) approaches. They found significant differences in diagnostic accuracy between the two methods, with poor agreement, highlighting the Stewart method’s potential superiority in capturing

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Miscellaneous

Macrophage pyroptosis and its crucial role in ALI/ARDS

Summary: “Macrophage Pyroptosis and its Crucial Role in ALI/ARDS” Abstract Summary: This comprehensive review explores macrophage pyroptosis, a specific form of programmed cell death, and its pivotal role in the pathogenesis of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Highlighting complex molecular pathways and inflammasome activation mechanisms, the authors detail the relationship

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Miscellaneous

Strategies for adapting under pressure: an interview study in intensive care units

Abstract Background Healthcare systems are operating under substantial pressures. Clinicians and managers are constantly having to make adaptations, which are typically improvised, highly variable and not coordinated across teams. This study aimed to identify and describe the types of everyday pressures in intensive care and the adaptive strategies staff use to respond, with the longer-term aim

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Mechanical Ventilation, Miscellaneous

Debate on the Role of Eccentric Contraction of the Diaphragm: Is It Always Harmful?

Abstract The diaphragm is the primary muscle involved in the ventilatory pump, making it a vital component in mechanical ventilation. Various factors in patients who require mechanical ventilation can lead to the deterioration of the diaphragm, which is associated with increased mortality. This deterioration can arise from either excessive or insufficient support due to improper

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Debate on the Role of Eccentric Contraction of the Diaphragm: Is It Always Harmful? Read Post »

Miscellaneous

Invasive fungal infections in patients with liver disease: immunological and clinical considerations for the intensive care unit

Abstract Patients with liver disease in the intensive care unit (ICU) face a unique susceptibility to infection due to the complex immune dysfunction resulting from hepatic failure. Bacterial infections are commonly present in these patients upon arrival to the hospital, often being the primary reason for ICU admission. In contrast, invasive fungal infections (IFIs) afflict

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Invasive fungal infections in patients with liver disease: immunological and clinical considerations for the intensive care unit Read Post »

Miscellaneous

Physiology and pathophysiology of mucus and mucolytic use in critically ill patients

Abstract Airway mucus is a highly specialised secretory fluid which functions as a physical and immunological barrier to pathogens whilst lubricating the airways and humifying atmospheric air. Dysfunction is common during critical illness and is characterised by changes in production rate, chemical composition, physical properties, and inflammatory phenotype. Mucociliary clearance, which is determined in part

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Miscellaneous

A review of gut failure as a cause and consequence of critical illness

Abstract In critical illness, all elements of gut function are perturbed. Dysbiosis develops as the gut microbial community loses taxonomic diversity and new virulence factors appear. Intestinal permeability increases, allowing for translocation of bacteria and/or bacterial products. Epithelial function is altered at a cellular level and homeostasis of the epithelial monolayer is compromised by increased

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