Obstetric Disorders and Critical Illness
In this article, we discuss some of the more common obstetric-related conditions that can lead to critical illness and require management in an ICU. These include the hypertensive disorders of pregnancy, postpartum hemorrhage, hemolysis, elevated liver enzymes, and low platelet syndrome, acute fatty liver of pregnancy, amniotic fluid embolism, and peripartum cardiomyopathy. We also discuss pulmonary embolism and Covid-19. Despite not being specific to obstetric patients, pulmonary embolism is a common, life-threatening diagnosis in pregnancy with particular risks and management aspects. Covid-19 does not seem to occur with...
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Kelly M. Griffin, Corrina Oxford-Horrey, Ghada Bourjeily Source Type: research
Advances in Ventilator Management for Patients with Acute Respiratory Distress Syndrome
The ventilatory care of patients with acute respiratory distress syndrome (ARDS) is evolving as our understanding of physiologic mechanisms of respiratory failure improves. Despite several decades of research, the mortality rate for ARDS remains high. Over the years, we continue to expand strategies to identify and mitigate ventilator-induced lung injury. This now includes a greater understanding of the benefits and harms associated with spontaneous breathing. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Michael C. Sklar, Laveena Munshi Source Type: research
Advances in Sepsis Care
This review article summarizes current scientific evidence regarding the treatment of sepsis. We highlight recent advances in sepsis management with a focus on antibiotics, fluids, vasopressors, and adjunctive therapies such as corticosteroids and renal replacement therapy. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Karen E. Jackson, Matthew W. Semler Source Type: research
Application of Focused Assessment with Sonography for Trauma in the Intensive Care Unit
The Extended-Focused Assessment with Sonography for Trauma (E-FAST) allows clinicians to rapidly diagnose traumatic thoracoabdominal injuries at the bedside without ionizing radiation. It has high specificity and is extremely useful as an initial test to rule in dangerous diagnoses such as hemoperitoneum, pericardial effusion, hemothorax, and pneumothorax. Its moderate sensitivity means that it should not be used alone as a tool to rule out dangerous thoracoabdominal injuries. In patients with a concerning mechanism or presentation, additional imaging should be obtained despite a negative FAST examination. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Molly E.W. Thiessen, Matthew Riscinti Source Type: research
Patient-Ventilator Synchrony
Patient-ventilator asynchrony develops when the ventilator output does not match the efforts of the patient and contributes to excess work of breathing, lung injury, and mortality. Asynchronies are categorized as trigger (breath initiation), flow (delivery of the breath), and cycle (transition from inspiration to expiration). Clinicians should be skilled at ventilator waveform analysis to detect patient-ventilator asynchronies and make informed ventilator adjustments. Ventilator overdrive suppresses respiratory drive and reduces asynchrony, while other adjustments specific to the asynchrony are also useful. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Kevin C. Doerschug Source Type: research
Extracorporeal Life Support in Respiratory Failure
Extracorporeal life support (ECLS) has a role in different types of respiratory failure including acute respiratory distress syndrome (ARDS), decompensated pulmonary hypertension, bridge to lung transplantation, and primary graft dysfunction after lung transplantation. ECLS in ARDS allows for lung-protective ventilation with the goal to reduce the risk of ventilator-induced lung injury. ECLS use in severe ARDS should be considered when conventional management strategies are not sufficient to safely support gas exchange. More research is needed to identify optimal mechanical ventilation during ECLS, weaning ECLS support, st...
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Briana Short, Kristin M. Burkart Source Type: research
Patient-Centered and Family-Centered Care in the Intensive Care Unit
Patient-centered and family-centered care (PFCC) is widely recognized as integral to high-quality health-care delivery. The highly technical nature of critical care puts patients and families at risk of dehumanization and renders the delivery of PFCC in the intensive care unit (ICU) challenging. In this article, we discuss the history and terminology of PFCC, describe interventions to promote PFCC, highlight limitations to the current model, and offer future directions to optimize PFCC in the ICU. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Katharine E. Secunda, Jacqueline M. Kruser Source Type: research
Survivorship After Critical Illness and Post-Intensive Care Syndrome
Improvements in critical care medicine have led to a marked increase in survivors of the intensive care unit (ICU). These survivors encounter many difficulties following ICU discharge. The term post -intensive care syndrome (PICS) provides a framework for identifying the most common symptoms which fall into three domains: cognitive, physical, and mental health. There are numerous risk factors for the development of PICS including premorbid conditions and specific elements of ICU hospitalizations. Management is complex and should take an individualized approach with interdisciplinary care. Future research should focus on pr...
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Leigh M. Cagino, Katharine S. Seagly, Jakob I. McSparron Source Type: research
Supporting Professionals in Critical Care Medicine
This article provides system-based practice and individual strategies to address these drivers and improve the well-being of our team and our patients. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Alexander S. Niven, Curtis N. Sessler Source Type: research
Evolution in Critical Care Medicine: Technology, Humanity, and a Global Pandemic
The evolution of critical care medicine is often marked and even led by technological advances in the diagnosis, monitoring, and treatment of life-threatening illness. This special issue of Clinics in Chest Medicine highlights major and recent technological advances in critical care —from bedside evaluation with ultrasound and capnography to novel diagnostic technology for common infections in the intensive care unit (ICU) to extracorporeal life support. Technological advances have changed not only bedside care but also the organization of critical care delivery—highlighted in a provocative account of the importance of...
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Jacqueline M. Kruser, Gregory A. Schmidt Tags: Preface Source Type: research
Critical Care
CLINICS IN CHEST MEDICINE (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Authors: Jacqueline M. Kruser, Gregory A. Schmidt Source Type: research
Copyright
ELSEVIER (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Source Type: research
Contributors
JACQUELINE M. KRUSER, MD, MS (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Source Type: research
Contents
Jacqueline M. Kruser and Gregory A. Schmidt (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Source Type: research
Forthcoming Issues
Cystic Fibrosis in the Era of Highly Effective CFTR Modulator Therapy (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - September 1, 2022 Category: Respiratory Medicine Source Type: research
