#CritCare
#OpenAccess
Prediction of fluid responsiveness is strongly influenced by a number of technical and clinical aspects which should be considered for individual intervention decisions.
Read the full article:
@jlvincen
@ISICEM
#FOAMed
#FOAMcc
No consistency in data reporting in studies on
#ICU
fluid responsiveness/challenge.
@ESICM
CODEFIRE consensus:
🔍18 experts
🔍3 step Delphi
🔍5 domains
🚪admission
🫁ventilation
💦reason for FC
🩸hemodynamics
💉drugs
🔍52 recommendations/suggestions
🖇️
NIVとHFNCについてのレビューなんだけど、さすがNEJM、よくまとまってます(偉そうにすみません)。
特にNIVの適応病態についてまとめたFigure. 1が秀逸なんです、
Noninvasive Respiratory Support for Adults with Acute Respiratory Failure | NEJM
AHAのAFガイドラインに、ついに急性期のAFの項ができたんですね👏
”10.10. Acute Medical Illness or Surgery (Including AF in Critical Care)”!
・塞栓リスク高いから外来フォローを検討
・敗血症治療中の塞栓予防の抗凝固薬使用のベネフィット分からない
ABCDEFバンドル遵守率と長期のPICSアウトカムの関連を調べたJ-PICS studyのサブ解析がCCMよりpublishされました!
一緒に協力してくださった皆様には頭が上がりません。
Evaluation of the Impact of ABCDEF Bundle Compliance Rates... : Critical Care Medicine
ARDSのPEEPの設定方法のレビュー
“best PEEP”は見つからない。
”better PEEP”を目指す
最後の一文↓が「不完全礼賛」と呼べるもので示唆に富む
“Give them the third best to go on with; the second best comes too late, the best never comes.”
Among patients with septic shock with tachycardia treated with norepinephrine for more than 24 hours, an infusion of the β-blocker landiolol did not reduce organ failure as measured by the SOFA score in the 14 days from randomization.
#ESICM
#LIVES2023
Extubation in neurocritical care, ENIO study:
🧠 78.9% extubation attempt
🧠 > 19% failure
🧠 direct tracheostomy primary liberation strategy
from IMV in 21% of pts;
🧠 validated score predicting success can be used
📎
Editorial
📎
Predicting good neuro outcome in comatose cardiac arrest survivors? Look at
🧠 GCS motor 4/5
🧠 normal NSE
🧠 SSEP N20 wave amplitude > 4 μV or continuous EEG background without discharges
🧠 no diffusion restriction in cortex or deep grey matter on MRI
SR
Resuscitation fluids,
@ESICM
guideline 🧵1/2
💦 for volume expansion use crystalloids vs albumin in critically ill pts in general, in
#sepsis
, ARF & periop + if risk for bleeding
💦 isotonic saline vs albumin in TBI & albumin vs crystalloids if cirrhosis
🔓
In this trial, a restrictive approach to intravenous fluid administration in critically ill patients with septic shock did not reduce mortality.
#CCR22
Critical illness is a transformative and often traumatic event for the entire family. The authors summarize data on the outcomes and highlight the need to frame ICU care as part of a continuum of care for critically ill patients.
#CriticalCare
In this randomized clinical trial, among critically ill adults undergoing tracheal intubation, administration of a fluid bolus did not significantly decrease the incidence of cardiovascular collapse.
#CCR22