Current opinion in critical care
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Patients admitted to ICUs are a heterogeneous group, displaying multiple anaemia risk factors and comorbidities. Clinicians should therefore take all possible measures to identify modifiable risks. Patient Blood Management (PBM) is an approach promoting the timely application of evidence-based interventions designed to maintain patients own blood mass. ⋯ Critically ill patients display various morbidities often requiring individualized treatment. PBM offers patient-centred measures to improve outcome any time during hospital stay.
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Curr Opin Crit Care · Dec 2021
ReviewThe world restart a heart initiative: how to save hundreds of thousands of lives worldwide.
Sudden out-of-hospital cardiac arrest (OHCA) is still one of the top reasons for death in industrialized countries. Bystander resuscitation rates differ significantly across the world despite bystanders being easily able to save lives in this situation. In the 4 years since initiation of the International Liaison Committee on Resuscitation (ILCOR) World Restart a Heart (WRAH), the initiative helped educating millions of people and thus enabled them to save lives. ⋯ The WRAH awareness campaign has reached 194 countries and more than 200 million people in the last years. The success of it could even be kept going in the pandemic due to social media and digital/virtual programmes. International guidelines recommend raising awareness and name ILCOR WRAH as a way to do it.
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Curr Opin Crit Care · Dec 2021
ReviewChanging resuscitation strategies during a pandemic: lessons from the consecutive surges in New York and global challenges.
To provide a framework for resuscitation of COVID-19 critical illness for emergency and intensive care clinicians with the most up to date evidence and recommendations in the care of COVID-19 patients in cardiac arrest or in extremis. ⋯ The resuscitation of critically ill COVID-19 patients poses new challenges, but the principles remain largely unchanged.
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To give an overview of cerebral monitoring techniques for surgical ICU patients. ⋯ Cerebral monitoring can be a valuable tool in the early detection of adverse outcomes in surgical ICU patients, but the evidence is limited, and clear clinical indications are still lacking.
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Curr Opin Crit Care · Dec 2021
ReviewTiming of renal-replacement therapy in intensive care unit-related acute kidney injury.
The optimal timing of renal-replacement therapy (RRT) initiation for the management of acute kidney injury (AKI) in the intensive care unit (ICU) is frequently controversial. An earlier-strategy has biological rationale, even in the absence of urgent indications; however, a delayed-strategy may prevent selected patients from receiving RRT and avoid complications related to RRT. ⋯ Early preemptive initiation of RRT in critically ill patients with AKI does not confer clear clinical benefits. However, protracted delays in RRT initiation may be harmful.