Current opinion in critical care
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We describe clinical and diagnostic features of various autoimmune and viral encephalitis subtypes. ⋯ Autoimmune and viral encephalitides can resemble one another and sometimes autoimmune encephalitis may be triggered by viral infections. Early diagnosis and treatment is the key to both causes, which emphasizes the importance of clinical diagnosis before laboratory confirmation.
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Curr Opin Crit Care · Apr 2018
Is hemoglobin good for cerebral oxygenation and clinical outcome in acute brain injury?
The purpose of this review is to highlight the role of hemoglobin in cerebral physiology and pathophysiology. We review the existing as well as recent evidence detailing the effects of red blood cell transfusion on cerebral oxygenation and clinical outcome. ⋯ Hemoglobin is important for cerebral oxygenation and strategies to minimize anemia should be undertaken. Although higher hemoglobin levels are associated with less cerebral ischemia and better clinical outcome, whether this remains true whenever red blood cell transfusion is used to achieve this result remains unclear.
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To provide an update on the relevant and recent studies on whole-body computed tomography (WBCT) imaging of severely injured patients. ⋯ On account of the recent advances, whole-body CT has become a crucial part of the initial in-hospital assessment of severely injured patients. It is recommended as the standard radiological tool for the emergency diagnostic work-up in major trauma patients.
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Curr Opin Crit Care · Feb 2018
ReviewWhen the momentum has gone: what will be the role of extracorporeal lung support in the future?
There has been expanding interest in and use of extracorporeal support in respiratory failure concurrent with technological advances and predominantly observational data demonstrating improved outcomes. However, until there is more available data from rigorous, high-quality randomized studies, the future of extracorporeal support remains uncertain. ⋯ Despite the ongoing rise in ECMO use for acute respiratory failure, its true value will not be known until more information is gleaned from prospective randomized controlled trials. Additionally, there are modalities beyond the current considerations for extracorporeal support that have the potential to revolutionize respiratory failure, particularly in the realm of chronic lung disease and lung transplantation.
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Curr Opin Crit Care · Feb 2018
ReviewIntermittent extracorporeal CO2 removal in chronic obstructive pulmonary disease patients: a fiction or an option.
Aim of this article is to review evidence recently generated on the application of extracorporeal carbon dioxide removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (invasive and non invasive) for hypercapnic respiratory failure. ⋯ Although several efforts have been made to reduce invasiveness and to improve the efficiency of extracorporeal systems, further randomized studies are needed to assess the effects of this technique on both short-term and long-term clinical outcomes.