Current opinion in critical care
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The aim of this study was to illustrate the varying roles of echocardiography in all phases of shock ranging from a rapid, diagnostic tool at the bedside, to a tool for monitoring the adequacy and effects of shock treatment and finally for identification of patients suitable for de-escalation of therapy. ⋯ This study provides the reader with a structured review on the uses of echocardiography in all phases of shock treatment.
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The purpose of this review was to provide an overview of head-up (HUP) CPR physiology, relevant preclinical findings, and recent clinical literature. ⋯ HUP CPR is a new and novel therapy increasingly used in the prehospital setting and discussed in the resuscitation community. This review provides a relevant review of HUP CPR physiology and preclinical work, and recent clinical findings. Further clinical studies are needed to further explore the potential of HUP CPR.
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To discuss the different techniques used to assess tissue oxygenation in critically ill patients. ⋯ Recent studies have highlighted the interest of surrogate measurements of tissue oxygenation and in particular PCO2 gradients.
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Muscle wasting in critical illness has proven to be refractory to physical rehabilitation, and to conventional nutritional strategies. This presents one of the central challenges to critical care medicine in the 21st century. Novel strategies are needed that facilitate nutritional interventions, identify patients that will benefit and have measurable, relevant benefits. ⋯ The evidence base for the lack of efficacy for conventional nutritional strategies in preventing muscle wasting in critically ill patients continues to grow. Novel strategies such as metabolic modulators, patient level biological signatures of nutritional response and standardized outcome for measurements of efficacy will be central to future research and clinical care of the critically ill patient.