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CriticalCare

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Textbook of Post-ICU Medicine

Surviving critical illness is not always the happy ending that we imagine for patients. Intensive care unit (ICU) teams have traditionally focused on short term goals such as stabilizing or reversing organ system dysfunction, with little understanding of what became of patients once they left the ICU. However, research conducted in recent years has demonstrated that many ICU survivors can suffer from ill health and mental health issues for months or years to follow. The Textbook of Post-ICU Medicine: The Legacy of Critical Care identifies the long term outcomes of ICU and the steps that can be taken to improve patients' health and wellbeing. Describing the major clinical syndromes affecting ICU survivors, the book delineates established or postulated biological mechanisms of the post-acute recovery process, and discusses strategies for treatment and rehabilitation to promote recovery in the ICU and in the long term. Many ICU survivors suffer from a range of long-lasting physical and psychological issues such as end stage renal disease, congestive heart failure, cognitive impairment, neuromuscular weakness, and depression or anxiety, which affect their overall quality of life and ability to lead productive lives. This book discusses the science of the recovery process and the innovative treatment regimens which are helping ICU survivors regain function as they heal following trauma or disease. This lingering burden or 'legacy' of critical illness is now recognized as a major public health issue, with major efforts underway to understand how it can be prevented, mitigated, or treated. The chapters are written by an interdisciplinary panel of leading clinicians and researchers working in the field. The book serves as a unique reference for general practitioners, internists and nurses caring for long term ICU survivors as well as specialists in intensive care medicine, neurology, psychiatry, and rehabilitation medicine.  
books.google.co.uk
over 5 years ago
Www.bmj
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India’s critical care doctors are highly stressed, survey finds

Between two fifths and three fifths of doctors who work in critical care units in India are moderately to severely stressed, show the results of a cross sectional survey published in the Indian Journal of Critical Care Medicine.1 The 242 respondents, all of whom were critical care doctors (85% male), were either full time intensivists or other specialists who spent at least half their day in critical care units.  
feeds.bmj.com
over 5 years ago
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Why Bruce Lee would have come to SMACC

So what does SMACC (Social Media And Critical Care) have to do with Bruce Lee? A lot I would argue! Bruce Lee, one of my all time heroes, is a legend in martial arts world and Hollywood. What he is not so well known for is his enthusiasm for philosophy ( he actually completed a…  
prehospitalmed.com
over 5 years ago
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Advanced airway management course - Intensive Care Network

This course, an addition to the BEYOND BASIC series, is designed to give the ICU trainee a structured approach to management of the upper airway.  
intensivecarenetwork.com
over 5 years ago
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FLASHBACK FRIDAY - BURNS - Intensive Care Network

Flashback Friday. We revisit Sydney HEMs doctor, Brian Burns' talk on prehospital management and retrieval medicine.  
intensivecarenetwork.com
over 5 years ago
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FLASHBACK FRIDAY - Intensive Care Network

Flashback Friday. We revisit Cliff Reid's inspirational talk on How to be a Hero. Presented at SMACC 2013.  
intensivecarenetwork.com
over 5 years ago
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Radiology Case 23 - Intensive Care Network

There is an AICD in-situ.  The right atrial and right ventricular leads are in satisfactory position, however the coronary sinus lead has migrated back into the superior vena cava.  
intensivecarenetwork.com
over 5 years ago
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Brown - Get Published! - Intensive Care Network

Anthony Brown shares his tips and tricks to maximise the chance for your paper to get published. This is a fantastic podcast which comes neatly packaged within 15 minutes.  
intensivecarenetwork.com
over 5 years ago
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FLASHBACK FRIDAY - Intensive Care Network

FLASHBACK FRIDAY! We re-visit the most popular ICN Posts in the lead up to SMACC Chicago! Check out the Social Media Q&A Panel (Weingart, Lex, Carley, Cadogan, Le Cong, Flower and Nickson) from SMACC 2013.  
intensivecarenetwork.com
over 5 years ago
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The Victorian Primary Examination Course for CICM (VPECC) - Intensive Care Network

ATTENTION ALL CICM PRIMARY EXAM CANDIDATES! Details about the VPECC primary examination course held in Melbourne on the 10th of October 2015.  
intensivecarenetwork.com
over 5 years ago
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Commencement 2015: Dr. Kirch’s Clip On Einstein-Montefiore Partnership

After visiting Montefiore Medical Center's adult and pediatric critical care units this week, Association of American Medical Colleges President and CEO Darr...  
youtube.com
over 5 years ago
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Critical Care

Intensive care is expensive, and thus a body of research has focused on strategies to reduce its costs. However, efforts to reduce the total cost of intensive care have met with limited success, partly because of the challenges of calculating how much a day in the ICU actually costs. We discuss these challenges and introduce the concept of total cost savings as an outcome of critical care trials, assuming statistically negative effects on mortality and quality of life.  
ccforum.com
over 5 years ago
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Critical Care

Goal-directed therapy (GDT) has been shown in numerous studies to decrease perioperative morbidity and mortality. The mechanism of benefit of GDT, however, has not been clearly elucidated. Targeted resuscitation of the vascular endothelium with GDT might alter the postoperative inflammatory response and be responsible for the decreased complications with this therapy.  
ccforum.com
over 5 years ago
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Critical Care

A recent meta-analysis showed that weaning with SmartCare™ (Dräger, Lübeck, Germany) significantly decreased weaning time in critically ill patients. However, its utility compared with respiratory physiotherapist–protocolized weaning is still a matter of debate. We hypothesized that weaning with SmartCare™ would be as effective as respiratory physiotherapy–driven weaning in critically ill patients.  
ccforum.com
over 5 years ago
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Critical Care

Neutrophil CD64 (nCD64) expression appears to be a promising marker of bacterial infections. The aim of this meta-analysis was to assess the accuracy of nCD64 expression for the diagnosis of sepsis in critically ill adult patients.  
ccforum.com
over 5 years ago
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Critical Care

We read with interest the recent articles in Critical Care about the limitations of pulse pressure variation (PPV) for predicting fluid responsiveness [1, 2]. We believe that cardiac dysfunction should be included in this list of PPV limitations.  
ccforum.com
over 5 years ago
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Critical Care

Intrinsic positive end-expiratory pressure (PEEPi) is a “threshold” load that must be overcome to trigger conventional pneumatically-controlled pressure support (PSP) in chronic obstructive pulmonary disease (COPD). Application of extrinsic PEEP (PEEPe) reduces trigger delays and mechanical inspiratory efforts. Using the diaphragm electrical activity (EAdi), neurally controlled pressure support (PSN) could hypothetically eliminate asynchrony and reduce mechanical inspiratory effort, hence substituting the need for PEEPe. The primary objective of this study was to show that PSN can reduce the need for PEEPe to improve patient-ventilator interaction and to reduce both the “pre-trigger” and “total inspiratory” neural and mechanical efforts in COPD patients with PEEPi. A secondary objective was to evaluate the impact of applying PSN on breathing pattern.  
ccforum.com
over 5 years ago
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Critical Care

We read with great interest the comments of Rocco and colleagues on colistin dosing in a recent letter in Critical Care [1]. The application of continuous renal replacement therapy (CRRT) indeed offers an opportunity to prescribe very high colistin doses without exposing the patient to excess toxicity [2]. However, caution is needed before implementing this so-called CRRT ‘shield’ function.  
ccforum.com
over 5 years ago
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Critical Care

Since the critical care physician will most likely be involved in a life-threatening expression of systemic mastocytosis, recognition of this disease is of utmost importance in the critical care management of these patients. Mastocytosis is a severely under-recognized disease because it typically occurs secondary to another condition and thus may occur more frequently than assumed. In this article, we will review the current knowledge on the treatment of mastocytosis crises with an emphasis on critical care management. Mastocytosis is characterized by the clonal proliferation and accumulation of mast cells in different tissues. Mast cell mediators contain a wide range of biologically active substances that may lead to itching and hives but may ultimately lead to anaphylactic shock caused by the release of histamine and other mediators from mast cells. The mainstay of therapy is the avoidance of potential triggers of mast cell degranulation and, if unsuccessful, blocking the cascade of mast cell mediators. The critical care physician should be well aware of the special precautions which should be kept in mind throughout the management of a mastocytosis crisis to avoid massive mast cell degranulation. Histamine-releasing drugs and certain physical triggers like temperature change should be avoided.  
ccforum.com
over 5 years ago