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Imaging and pulmonary function techniques in ARDS diagnosis and management: current insights and challenges

đŸ« Are CT, LUS, and EIT the missing link to truly personalized ARDS care? Abstract: This narrative review argues that integrating chest CT, lung ultrasound (LUS), and electrical impedance tomography (EIT) with key physiology (compliance, driving pressure, transpulmonary pressure, mechanical power) can sharpen ARDS diagnosis and enable more individualized ventilation. The authors endorse a tiered […]

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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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The Zentensivist Manifesto. Defining the Art of Critical Care

Summary This perspective piece introduces the concept of “zentensivism,” a minimalist and holistic approach to critical care medicine that seeks to counteract the harmful tendency towards excessive medical interventions. Combining Zen philosophy with the core principles of evidence-based medicine, zentensivism advocates for careful clinical reasoning, thoughtful inaction, and patient-centered care. The authors discuss the necessity

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Prone positioning during veno-venous extracorporeal membrane oxygenation: a systematic review and meta-analysis

Summary Pettenuzzo et al. conducted a comprehensive systematic review and meta-analysis evaluating the effects of prone positioning during veno-venous extracorporeal membrane oxygenation (V-V ECMO) in patients with acute hypoxemic respiratory failure. Analyzing data from 22 studies (3,465 patients), the review concluded that prone positioning is associated with significantly improved 28-day and hospital mortality rates despite

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ARDS Ventilation, The Man Behind the Evolution

Summary This commentary highlights the significant advancements made in the management of Acute Respiratory Distress Syndrome (ARDS) since its initial description by Ashbaugh et al. in 1967. Central to these advancements is Prof. Luciano Gattinoni, whose groundbreaking contributions, particularly the concepts of the “baby lung,” ventilator-induced lung injury, and prone positioning, transformed ARDS management. The

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A Critical Reappraisal of Haloperidol for Delirium Management in the Intensive Care Unit: Perspective from Psychiatry

Summary: “A Critical Reappraisal of Haloperidol for Delirium Management in the Intensive Care Unit: Perspective from Psychiatry” Abstract Summary: This review critically examines the use of haloperidol for managing delirium in ICU settings from a psychiatric perspective. Despite historical and ongoing use of haloperidol, recent randomized controlled trials (RCTs) have questioned its effectiveness, primarily due

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Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study

Summary: Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study Abstract Summary: This multicentre observational study by Arabi and colleagues investigates the impact of mechanical ventilation (MV) timing on outcomes in 672 patients with STEMI complicated by cardiogenic shock (CS). The

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Timing of mechanical ventilation and its association with in-hospital outcomes in patients with cardiogenic shock following ST-elevation myocardial infarction: a multicentre observational study Read Post »

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Practical approach to thrombocytopenia in patients with sepsis: a narrative review

Summary of Practical approach to thrombocytopenia in patients with sepsis: a narrative review Abstract: Thrombocytopenia is common in sepsis, with disseminated intravascular coagulation (DIC) being a frequent cause, though thrombotic microangiopathy (TMA)—including thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS)—is increasingly recognized. Differentiating DIC from TMA is challenging due to overlapping clinical and laboratory

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Extracorporeal Cardiopulmonary Resuscitation—Where Do We Currently Stand?

Abstract Extracorporeal cardiopulmonary resuscitation (eCPR) is a method of acute resuscitation for patients who have suffered a cardiac arrest through the utilization of an extracorporeal membrane oxygenation (ECMO) pump. The use and efficacy of eCPR is an active area of investigation with ongoing clinical investigation across the world. Since its inception, ECMO has been utilized

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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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