Critical Care

  • Are daily chest radiographs and arterial blood gas tests required in ICU patients on mechanical ventilation?
    Shyam Ganti, MD, Ravinder D. Bhanot, MD, Jasleen Kaur, MD, Cassondra Cramer-Bour, MD and Ayman O. Soubani, MD
    Cleveland Clinic Journal of Medicine September 2019, 86 (9) 582-585; DOI: https://doi.org/10.3949/ccjm.86a.18141

    Although routine testing is common, it has low diagnostic yield and is unlikely to alter patient management.

  • Disseminated invasive aspergillosis in an immunocompetent patient
    Jessica McLaughlin, DO, Eric Libre, MD, FCCP, Amanda Morgan, MD and Svetolik Djurkovic, MD, FCCP
    Cleveland Clinic Journal of Medicine June 2019, 86 (6) 369-370; DOI: https://doi.org/10.3949/ccjm.86a.18093

    The patient, who has COPD, will require lifelong antifungal treatment.

  • Is chest radiography routinely needed after thoracentesis?
    Aibek E. Mirrakhimov, MD, Aram Barbaryan, MD, Taha Ayach, MD, Fabrizio Canepa Escaro, MD, Goutham Talari, MD and Adam Gray, MD
    Cleveland Clinic Journal of Medicine June 2019, 86 (6) 371-373; DOI: https://doi.org/10.3949/ccjm.86a.17058

    No, it should be done only in certain situations, for example, if pneumothorax is suspected.

  • Anti-Xa assays: What is their role today in antithrombotic therapy?
    Erika Hutt Centeno, MD, Michael Militello, PharmD, RPH, BCPS and Marcelo P. Gomes, MD
    Cleveland Clinic Journal of Medicine June 2019, 86 (6) 417-425; DOI: https://doi.org/10.3949/ccjm.86a.18029

    Should clinicians abandon the aPTT for monitoring heparin therapy in favor of anti-Xa assays?

  • Heart failure guidelines: What you need to know about the 2017 focused update
    Lee Rodney Haselhuhn, MD, Daniel J. Brotman, MD and Ilan Shor Wittstein, MD
    Cleveland Clinic Journal of Medicine February 2019, 86 (2) 123-139; DOI: https://doi.org/10.3949/ccjm.86a.18022

    Prevention, preserved ejection fraction, hypertension, iron, sleep apnea, and acute decompensation.

  • Managing malignant pleural effusion
    Ali Saeed Wahla, MBBS, Mateen Uzbeck, MBBS, Yaser Abu El Sameed, MBBS and Zaid Zoumot, MBBS, MRCP, MSC, PHD
    Cleveland Clinic Journal of Medicine February 2019, 86 (2) 95-99; DOI: https://doi.org/10.3949/ccjm.86a.17095

    Depending on the circumstances, options are observation, thoracentesis, an indwelling catheter, and chemical pleurodesis.

  • Shortness of breath, fever, cough, and more in an elderly woman
    Brody D. Slostad, MD, Megha Prasad, MD and Nandan S. Anavekar, MD
    Cleveland Clinic Journal of Medicine September 2018, 85 (9) 685-692; DOI: https://doi.org/10.3949/ccjm.85a.18030

    The patient’s many problems include ventricular tachycardia, requiring an implanted cardioverter-defi brillator and amiodarone.

  • Which patients with a parapneumonic effusion need a chest tube?
    Scott A. Helgeson, MD, Brett T. Hiroto, MD, Scott J. Billings, MD, Courtney L. Scott, DO and Michele D. Lewis, MD
    Cleveland Clinic Journal of Medicine August 2018, 85 (8) 609-611; DOI: https://doi.org/10.3949/ccjm.85a.17036

    Hospitalized patients with pneumonia who develop a complicated effusion or empyema need one.

  • What should I address at follow-up of patients who survive critical illness?
    Dmitriy M. Golovyan, MD, Sikandar H. Khan, DO, Sophia Wang, MD and Babar A. Khan, MBBS
    Cleveland Clinic Journal of Medicine July 2018, 85 (7) 523-526; DOI: https://doi.org/10.3949/ccjm.85a.17104

    Cognitive decline, psychiatric disturbances, and physical weakness can persist 1 year or longer.

  • Critical care medicine: An ongoing journey
    Steven R. Insler, DO
    Cleveland Clinic Journal of Medicine July 2018, 85 (7) 527-528; DOI: https://doi.org/10.3949/ccjm.85a.18015

    Although 70% of ICU patients survive hospitalization, the mortality rate 1 year after discharge may exceed 50%.

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