A 29 page PDF which is pretty extensive in its coverage of the perioperative management regarding medications in the CTS patients. It's free and a must-read for everyone taking care of this patient population
Antibiotic therapy, supportive treatment and management of immunomodulation-inflammation response in community acquired pneumonia: review of recommendations
This is also an open access article. Some of the goodies of the include:
"There are no specific recommendations regarding the proper duration of antibiotic treatment"
- So the 8 days vs. 14 days assumptions go out the door.
"the duration of antibiotic treatment can be guided by the trend of procalcitonin levels; antibiotic could be interrupted when PCT levels reach 0.1 ng/ml"
- We should be checking PCT, acknowledging the limitations of this, during the course of the ICU stay.
"patients with more severe respiratory failure (PaO2/FiO2 < 200) had lower risk of intubation if treated with HFNC compared to traditional oxygen or NIV, indicating a possible role of this technique in this type of patients"
- There are other studies that show HFNC to be superior to NIV(BiPAP) in PNA.
We also don't need to give vancomycin and zosyn to everyone who comes to our ICU's with PNA
Acute-on-chronic liver failure: recent update
This is more of a pathophysiology article rather and a how to manage article. I am not going to lie, I just skimmed through this article as it was a bit too dense for what I can process right now. I'll get back to this one at some point soon.
Update in Management of Severe Hypoxemic Respiratory Failure
This one is a contemporary review from Chest; the need to know articles.
Key points:
- if the P/F ratio <150, think about paralyzing and proning
- tidal volume of 4-8 cc/kg of IBW, decrease to 4 if plateau presses > 30 (if chest wall is normal)
- there's some cool info regarding high PEEP vs. low PEER and mortality
- they explain some recruitment maneuvers
- table 3 has some key potential benefits of prone positioning
- there's a nice management flow chart towards the end.
- needless to say, I printed a bunch of these out and handed them to my staff.
Efficacy and safety of a balanced salt solution versus a 0.9% saline infusion for the prevention of contrast-induced acute kidney injury (BASIC trial): a study protocol for a randomized controlled trial
A heads up on a study being performed in South Korea which is basically NS vs. what we call plasma-lyte here in the States. He's the kicker, it's being sponsored by the pharmaceutical company producing the balanced salt solution.
Once again, thanks to Rob Mac Sweeney at criticalcarereviews.com. You should definitely subscribe to his email list and check out his work.
-EJ
Although great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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