Critical care clinics
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Critical care clinics · Apr 2022
Review Case ReportsCommon Presentations of Rare Drug Reactions and Atypical Presentations of Common Drug Reactions in the Intensive Care Unit.
Adverse drug events (ADRs) are a significant source of iatrogenic injury that may be challenging to diagnose and treat. Patient outcomes range from mild symptoms to death. Critically ill children are at unique risk for ADR development because of age-dependent pharmacokinetic differences and off-label prescribing.
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Critical care clinics · Apr 2022
ReviewRapid Exome and Genome Sequencing in the Intensive Care Unit.
Rapid genomic sequencing has become a powerful diagnostic tool for critically ill children. Accumulated data support clinical utility. ⋯ Cost savings to health care institutions are not only the result of reduced sequencing charges (which have paralleled advances in sequencing technology), but also and more specifically have impact on diagnosis-specific medical management and reduced length of hospitalization. The use of genomic sequencing in critical care is still primarily limited to academic centers but will ultimately become the wider-spread standard of care for select patients.
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Critical care clinics · Apr 2022
ReviewZebras Seize the Day: Rare Causes of Status Epilepticus Across the Continuum of Critical Care.
Status epilepticus (SE) is a common neurologic emergency and is associated with a high risk of morbidity and mortality. The management of SE in the intensive care unit centers on stabilization and treatment, as well as identifying and treating the underlying etiology. Numerous etiologies of SE are amenable to treatment, including certain genetic and metabolic disorders, autoimmune encephalitis and other inflammatory disorders, intracranial infections, and toxic/metabolic derangements. This article highlights rare but important causes of SE across the continuum of care from neonates to adults.
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Shock is a state in which the cardiovascular system fails to adequately deliver required substrates to maintain end-organ perfusion, tissue homeostasis, and cellular metabolism. Rapid recognition of shock and intervention is of utmost importance to reverse the shock state. This article reviews uncommon etiologies of shock classified in the following categories: distributive, hypovolemic, cardiogenic, and dissociative shock.