1,721,294 research outputs found
Exploring Associations Between Respiratory Mechanics and Survival in Immunocompromised Patients With ARDS
No full textThanks to improvements in organ support strategies and to advances in the treatment of solid and hematological
tumors, outcome of immunocompromised patients requiring ICU admission has improved impressively over the last decade . For this reason, the number of immunocompromised patients admitted to the ICU and deemed candidates for invasive therapies is steadily increasing. Acute respiratory failure (ARF) is the leading cause of hospital and ICU admission, but the optimal first-line
reatment of respiratory failure in these patients remains to be determine
Length of remdesivir treatment in patients with severe covid-19
Full text linkIn severe COVID-19, a 5-day remdesivir regimen seems as effective as a 10-day course of treatment and it may be safer. To date, the drug has no clearly proven efficacy over time
Empirical decision-making for antimicrobial therapy in critically ill patients
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Obstructive sleep apnoea syndrome: What the anesthesiologist should know
No full textObstructive sleep apnoea syndrome (OSAS) is a rather common sleep disorder and
constitutes a risk or an aggravating factor for various underlying diseases. OSAS is
characterised by repeated upper airway collapse during sleep causing fragmented
sleep, hypoxemia and hypercapnia. It may also cause considerable changes in intrathoracic
pressure and an increase in sympathetic nervous activity, which represent
the basis of associated pathologies such as arterial hypertension, ischaemic heart
disease, diabetes mellitus, stroke and sudden death [1]. Moreover, there is a wellestablished
association between OSAS and postoperative complications [2, 3].
Nevertheless, a significant proportion of patients affected by OSAS undergo surgery
without diagnosis and, consequently, without therapy [4]. Therefore, it is crucial for
the anaesthesiologist to identify patients at risk of OSAS before surgery for a correct
definition of a perioperative strategy to reduce the risk of perioperative complication.
This process should be done independently and regardless of whether the
patient undergoes general or locoregional anaesthesia
Physiopathological rationale of using high-flow nasal therapy in the acute and chronic setting: A narrative review
Full text linkChronic lung disease and admissions due to acute respiratory failure (ARF) are becoming increasingly common. Consequently, there is a growing focus on optimizing respiratory support, particularly non-invasive respiratory support, to manage these conditions. High flow nasal therapy (HFNT) is a noninvasive technique where humidified and heated gas is delivered through the nose to the airways via small dedicated nasal prongs at flows that are higher than the rates usually applied during conventional oxygen therapy. HFNT enables to deliver different inspired oxygen fractions ranging from 0.21 to 1. Despite having only recently become available, the use of HFNT in the adult population is quite widespread in several clinical settings. The respiratory effects of HNFT in patients with respiratory failure may be particularly relevant for clinicians. In this narrative review, we discuss the main pathophysiological mechanism and rationale for using HFNT in the acute and chronic setting
Rationale and evidence on the use of tocilizumab in COVID-19: A systematic review. Authors’ reply
No full textCardiac arrest in older adult patients
No full textPURPOSE OF REVIEW: To describe the epidemiology, prognostication, and treatment of out- and in-hospital cardiac arrest (OHCA and IHCA) in elderly patients. RECENT FINDINGS: Elderly patients undergoing cardiac arrest (CA) challenge the appropriateness of attempting cardiopulmonary resuscitation (CPR). Current literature suggests that factors traditionally associated with survival to hospital discharge and neurologically intact survival after CA cardiac arrest in general (e.g. presenting ryhthm, bystander CPR, targeted temperature management) may not be similarly favorable in elderly patients. Alternative factors meaningful for outcome in this special population include prearrest functional status, comorbidity load, the specific age subset within the elderly population, and CA location (i.e., nursing versus private home). Age should therefore not be a standalone criterion for withholding CPR. Attempts to perform CPR in an elderly patient should instead stem from a shared decision-making process. SUMMARY: An appropriate CPR attempt is an attempt resulting in neurologically intact survival. Appropriate CPR in elderly patients requires better risk classification. Future research should therefore focus on the associations of specific within-elderly age subgroups, comorbidities, and functional status with neurologically intact survival. Reporting must be standardized to enable such evaluation
Inclusion of pregnant women in clinical trials of COVID-19 therapies: what have we learned?
No full textGlobal warming "heating up" the ICU through Candida auris infections: The climate changes theory
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