Search results for " Critical care"

Blood Component Therapy and Coagulopathy in Trauma: A Systematic Review of the Literature from the Trauma Update Group

2016

Background Traumatic coagulopathy is thought to increase mortality and its treatment to reduce preventable deaths. However, there is still uncertainty in this field, and available literature results may have been overestimated. Methods We searched the MEDLINE database using the PubMed platform. We formulated four queries investigating the prognostic weight of traumatic coagulopathy defined according to conventional laboratory testing, and the effectiveness in reducing mortality of three different treatments aimed at contrasting coagulopathy (high fresh frozen plasma/packed red blood cells ratios, fibrinogen, and tranexamic acid administration). Randomized controlled trials were selected alo…

Cisternostomy for Traumatic Brain Injury: A New Era Begins

2016

Traumatic brain injury (TBI) is a major cause of death and disability especially in the young generations. In the United States TBI affects about 1.7 million people annually [1] and this number is higher in the developing countries. It is well known that TBI is associated to a primary and secondary brain injury. The first is without solution and depends on the impact. In surviving patients, what plays a critical role is the subsequent secondary injury since, without effective treatments, complex cascades will promote additional brain damage.

Neuro-ICU patient disposition

2018

This article revises the recent evidence on ICU admission criteria for acute neurological patients [traumatic brain injury (TBI) patients, postoperative neurosurgical procedures and stroke].The appropriate utilization of ICU beds is essential, but it is complex and a challenge to attain. To date there are no widely accepted international guidelines for managing these acute brain-injured patients (stroke, TBI, postneurosurgery) in the ICU. The criteria for ICU admission after neurological acute injury, high-dependency unit or a specialized neurosurgical ward vary from institution to institution depending on local structures and characteristics of the available resources. Better evidence to s…

Vasopressor-Sparing Strategies in Patients with Shock: A Scoping-Review and an Evidence-Based Strategy Proposition

2021

Despite the abundant literature on vasopressor therapy, few studies have focused on vasopressor-sparing strategies in patients with shock. We performed a scoping-review of the published studies evaluating vasopressor-sparing strategies by analyzing the results from randomized controlled trials conducted in patients with shock, with a focus on vasopressor doses and/or duration reduction. We analyzed 143 studies, mainly performed in septic shock. Our analysis demonstrated that several pharmacological and non-pharmacological strategies are associated with a decrease in the duration of vasopressor therapy. These strategies are as follows: implementing a weaning strategy, vasopressin use, system…

Proceedings of Réanimation 2017, the French Intensive Care Society International Congress

2017

The EasyTube during general anesthesia for minor surgery

2017

BACKGROUND The EasyTube (EzT) is a supraglottic airway device that is used for emergency airway situations. Ventilation during general anesthesia should also be feasible, but literature on the EzT is scarce. We evaluated the EzT in comparison with the endotracheal tube (ETT) in its use during general anesthesia in a comparative study. METHODS A total of 400 patients with American Society of Anesthesiologists (ASA) physical status I to II scheduled for minor surgery in 4 centers were randomized for ventilation via the ETT or EzT. RESULTS In all patients, the EzT and the ETT could be inserted within 3 attempts. In all EzT patients, the inspiratory and expiratory minute volumes (6.64 ± 0.71 an…

Wache Videolaryngoskopie

2016

Introduction Awake video laryngoscopy is a novel option in airway management that is drawing more and more attention as an alternative to awake endoscopic guided intubation.Main issues: Intubation under preserved spontaneous breathing is the safest method to secure the expected difficult airway. In direct comparisons to awake flexible endoscopic intubation, awake video laryngoscopy achieves satisfactory intubation times and a high acceptance of patients and anesthesiologists. Specific cases, in particular very limited mouth opening or sub-glottic masses, require awake flexible endoscopic intubation. Sufficient topical anesthesia and a sophisticated sedation protocol are prerequisites for su…

Management of Acute Kidney Injury and Extracorporeal Blood Purification Therapies During the COVID-19 Pandemic: The Italian SIN–SIAARTI Joint Survey …

2022

Background and AimThe novel coronavirus disease 2019 remains challenging. A large number of hospitalized patients are at a high risk of developing AKI. For this reason, we conducted a nationwide survey to assess the incidence and management of AKI in critically ill patients affected by the SARS-CoV-2 infection.MethodsThis is a multicenter, observational, nationwide online survey, involving the Italian Society of Nephrology and the critical care units in Italy, developed in partnership between the scientific societies such as SIN and SIAARTI. Invitations to participate were distributed through emails and social networks. Data were collected for a period of 1 week during the COVID-19 pandemic…

Awake tracheotomy in a patient with stridor and dyspnoea caused by a sizeable malignant thyroid tumor: a case report and short review of the literatu…

2017

Key Clinical Message Individual airway management is mandatory in patients with large goiters undergoing thyroid surgery. Preoperative endoscopic airway evaluation and imaging studies can support clinical decision making. Awake tracheotomy can be an effective and reasonable airway management strategy in such patients.

Fake news and patient-family-physician interaction in critical care: concepts, beliefs and potential countermeasures

2020

Fake news has been defined as fabricated information mimicking media content in form but not in organizational process or intent. Science and medicine are deeply affected by this increasing phenomenon. Critical care represents a hot spot for fake news due to the high risk of conflictive communication, the rapid turnaround of clinical news and high prevalence of unpleasant information. Communication with patients' relatives is one of the hardest aspects. The relationship between physicians and families is pivotal to improve relatives' comfort, and reduce anxiety and pain. Fake news may undermine this relationship, posing an alternative truth between the critical care physician and relatives,…