Journal of critical care
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Journal of critical care · Feb 2021
ReviewOutcomes of severe Legionella pneumonia requiring extracorporeal membrane oxygenation (ECMO).
Legionella pneumonia with acute respiratory failure may necessitate extracorporeal membrane oxygenation (ECMO). The medical literature in this area is comprised primarily of case reports and small case series. Our goal was to summarize published data and contribute our institutional experience regarding survival in severe Legionella pneumonia requiring ECMO. ⋯ Review of clinical experience with ECMO for severe Legionella pneumonia yields a survival rate of over 70%. The similarity in survival rates among all published cases (78.1%), case series reporting surviving and non-surviving patients (71.7%), our institutional experience (80%), and recently reported Extracorporeal Life Support Organization (ELSO) registry data (71%) supports the veracity of this encouraging survival rate.
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Journal of critical care · Feb 2021
Observational StudyMicrocirculation alterations in severe COVID-19 pneumonia.
To assess the presence of sublingual microcirculatory and skin perfusion alterations in COVID-19 pneumonia. ⋯ COVID-19 patients showed an altered tissue perfusion. Sublingual microcirculation was characterized by decreases in the proportion of perfused vessel and flow velocity along with high vascular densities. This last finding might be related to enhanced angiogenesis or hypoxia-induced capillary recruitment.
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Journal of critical care · Feb 2021
Case ReportsThe clinical spectrum of pulmonary thromboembolism in patients with coronavirus disease-2019 (COVID-19) pneumonia: A European case series.
To describe the clinical characteristics and outcomes of coronavirus disease-2019 (COVID-19)-associated pulmonary thromboembolism (PTE). ⋯ PTE is a potential life-threatening complication, which occurs frequently in patients with COVID-19. Intermediate therapeutic dose of anticoagulants and extend thromboprophylaxis are necessary after meticulous risk-benefit assessment.
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Journal of critical care · Feb 2021
Safety and efficacy of vasopressor administration through midline catheters.
Vasopressors are commonly administered through Central Venous Catheters (CVCs) as it is considered unsafe to administer them via peripheral IVs, mainly due to the concern of local tissue injury. Unlike peripheral IVs, midline catheters provide a wider lumen with the catheter tip ending in a large peripheral vein. The use of vasopressors through midline catheters has not yet been evaluated. ⋯ Many medical centers are attempting to limit the use of central venous catheters (CVCs) to avoid central line-associated bloodstream infections (CLABSIs). This study demonstrates that midline catheters are a safe alternative to CVCs, for the safe and efficacious administration of vasopressors for prolonged periods of time.