Critical Care
- 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.
- Which patients hospitalized with alcohol withdrawal syndrome should receive high-dose parenteral thiamine?
The authors briefly outline risk factors for Wernicke encephalopathy and when high-dose parenteral thiamine is indicated.
On the horizon: Extracorporeal carbon dioxide removalExtracorporeal carbon dioxide removal to treat hypercapnic respiratory failure has been studied in acute respiratory distress syndrome, chronic obstructive pulmonary disease, asthma, and other conditions.
- Steroids in the acutely ill: Evolving recommendations and practice
New information has been generated with regard to what causes critical illness-related corticosteroid insufficiency, how to diagnose it, who should receive corticosteroid treatment, and what regimens to use.
- Neuropsychiatric assessment and management of the ICU survivor
Post-intensive care syndrome occurs in 50% to 70% of ICU survivors. The authors examine various facets of this syndrome and emphasize the role of post-ICU recovery clinics.
- Spontaneous coronary artery dissection: Principles of management
Once thought to be rare, it is increasingly recognized as a common cause of acute coronary syndrome, particularly in young women.
- Fungus among us: A poster child for diagnostic stewardship
When interpreting the significance of Aspergillus species in respiratory culture, first ask if the culture was clinically indicated, or if this was an incidental finding.
- Is Aspergillus isolated from respiratory cultures clinically significant?
Aspergillus is ubiquitous, so the significance of the finding depends on the patient’s symptoms, underlying lung condition, immune status, and radiologic fi ndings.