Current opinion in critical care
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Postoperative neurocognitive disorders (NCD) are significant causes of morbidity and mortality. In this paper, we will review our understanding and potential management of postoperative NCD. ⋯ A spectrum of NCD exists in surgical patients ranging from postoperative delirium, delayed neurocognitive recovery, and POCD. Identification of patients at-risk for developing NCD can help target appropriate perioperative intervention. Also, specialized care teams and the implementation of standardized protocols are crucial for the successful management perioperative NCD. Finally, large, randomized, multicenter studies are needed to confirm benefits of preventive and treatment strategies.
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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
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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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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The aim of this study was to outline the management of the patient with the open abdomen. ⋯ Changes in the treatment of patients with the open abdomen include negative temporary closure, conservative fluid management, early protective lung ventilation, decreased sedation and extubation before abdominal closure in selected patients.