Current opinion in critical care
-
Curr Opin Crit Care · Apr 2021
ReviewPrevention of gastrointestinal bleeding in critically ill patients.
This review focuses on the current literature on the epidemiology and prevention of stress-induced clinically important gastrointestinal bleeding in ICU patients. ⋯ The incidence of stress-induced clinically important gastrointestinal bleeding in critically ill patients seems to have decreased over time. Even though stress ulcer prophylaxis in critically ill patients has been a research focus for decades, many questions remain unanswered, such as which groups of patients are likely to benefit and what pharmacologic agent is associated with the best benefit-to-harm ratio.
-
Curr Opin Crit Care · Aug 2021
ReviewVitamin D in critical care: where are we now and what is next?
To summarize the recent evidence on the role of vitamin D deficiency in critically ill patients and emerging data claiming a role of vitamin D in COVID-19. ⋯ Although research on this topic is still ongoing, it appears reasonable to recommend at least the standard vitamin dose for the healthy population (600--800 IU of native vitamin D3). Many questions remain on the actual role, the best metabolite, regime, and so forth. However, the role for vitamin D in bone health is clear. Elderly ICU survivors have a high risk for osteoporosis/fractures, so at least in this population, an optimal vitamin D status should be targeted.
-
Curr Opin Crit Care · Apr 2021
ReviewLung-protective ventilation and adjunctive strategies to manage respiratory failure: are they safe in the neurological patient?
The coexistence of neurological injury and respiratory failure is common in intensive care. This article provides a contemporary overview of the safety and efficacy of different strategies for mechanical ventilation and adjunctive respiratory approaches in patients with acute brain injury. ⋯ Research is needed to determine the safety, feasibility, and efficacy of LPV and adjunctive approaches for managing patients with concurrent brain injury and respiratory failure.
-
Mechanical ventilation is frequently needed in patients with cardiogenic shock. The aim of this review is to summarize and discuss the current evidence and the pathophysiological mechanism that a clinician should consider while setting the ventilator. ⋯ Evidence is growing regarding the role of lung failure as adverse prognostic factor and beneficial effect of positive pressure ventilation as part of first-line treatment in patients with cardiogenic failure.
-
To describe recent science in basic life support (BLS) after cardiac arrest and how evolving knowledge in resuscitation is changing current guidelines and practices. ⋯ This review highlights the importance of strengthening both community and emergency medical services efforts to improve outcomes in cardiac arrest. Strategies that enhance the communication and collaboration between lay rescuers and professional resuscitation systems are important new avenues to pursue in developing systems that save more lives.