Critical Care
Managing right ventricular failure in the setting of pulmonary embolismThe authors review current management strategies, including medical, percutaneous interventional, and surgical options, and discuss recent advances in the field.
- How can I better recognize and manage delirium in my hospitalized patients?
By knowing common precipitants and mimickers of delirium and considerations for workup, clinicians can implement nonpharmacologic preventive strategies, better identify patients experiencing delirium, and optimize symptom management.
- Shortness of breath in a 52-year-old man with HIV and severe mitral regurgitation
The patient presented with 3 weeks of acute on chronic dyspnea on exertion with progression to dyspnea at rest and associated orthopnea.
- What fluids should I order for my patient with acute pancreatitis?
Recent data show that moderate fluid resuscitation is associated with fewer adverse events and that lactated Ringer’s may be superior to normal saline.
- Do patients with sepsis benefit from intravenous albumin?
Patients with sepsis who do not need vasopressors do not benefit from intravenous albumin compared with intravenous crystalloid therapy alone.
- Does my patient with acute variceal hemorrhage need a transjugular intrahepatic portosystemic shunt?
Placement of a transjugular intrahepatic portosystemic shunt can be used as salvage therapy to control bleeding when endoscopic management fails and as a means of secondary prophylaxis in select patients.
- Do I always need a central venous catheter to administer vasopressors?
Although generally preferred, central venous catheters carry risks such as procedural complications, infection, and thrombosis. Clinicians must assess, case by case, whether a peripheral intravenous catheter can be used.
- What is the role for terlipressin in hepatorenal syndrome?
The drug is recommended as a first-line treatment of hepatorenal syndrome-related acute kidney injury, but it is associated with respiratory failure, especially in the setting of albumin administration, and certain comorbidities may increase the risk.
- COVID-19: A management update
The authors examine current guidelines of the Infectious Diseases Society of America and the National Institutes of Health.
- Should midodrine be used as an intravenous vasopressor-sparing agent in septic shock?
Research and robust data are still lacking regarding use of midodrine in this setting.