Thrombolysis in Pulmonary Embolism
Acute pulmonary embolism (PE) is associated with high in-hospital morbidity and mortality, both via cardiorespiratory decompensation and the bleeding complications of treatment. Thrombolytic therapy can be life-saving in those with high-risk PE, but requires careful patient selection. Patients with PE and systemic arterial hypotension ( “massive PE”) should receive thrombolytic therapy unless severe contraindications are present. Patients with PE and right ventricular dysfunction/injury, but without hypotension (“submassive PE”), should be considered for thrombolysis on a case-by-case basis, conside...
Source: Critical Care Clinics - May 28, 2020 Category: Intensive Care Authors: Eric Kaplovitch, Joseph R. Shaw, James Douketis Source Type: research

Erratum
Please note the following correction in the article Opal SM, Wittebole X. Biomarkers of Infection and Sepsis. Crit Care Clin 2020;36(1):11-22: Reference number 65 should be Miller RR, Lopansri BK, Burke JP, et  al. Validation of a host response assay, SeptiCyte LAB, for discriminating sepsis from systemic inflammatory syndrome in the ICU. Am J Respir Crit Care Med 2018;198(7):904-13. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2020 Category: Intensive Care Source Type: research

Pulmonary Embolism in the ICU
CRITICAL CARE CLINICS (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2020 Category: Intensive Care Authors: Bharat Awsare, Michael Baram, Geno Merli Source Type: research

Copyright
ELSEVIER (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2020 Category: Intensive Care Source Type: research

Contributors
JOHN A. KELLUM, MD, MCCM (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2020 Category: Intensive Care Source Type: research

Contents
Erratumxi (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2020 Category: Intensive Care Source Type: research

Forthcoming Issues
Part I: Enhanced Recovery in the ICU After Cardiac Surgery (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2020 Category: Intensive Care Source Type: research

Risk Stratification of Pulmonary Embolism
Given the broad treatment options, risk stratification of pulmonary embolism is a highly desirable component of management. The ideal tool identifies patients at risk of death from the original or recurrent pulmonary embolism. Using all-cause death in the first 30-days after pulmonary embolism diagnosis as a surrogate, clinical parameters, biomarkers, and radiologic evidence of right ventricular dysfunction and strain are predictive. However, no study has demonstrated improved mortality rates after implementation of a risk stratification strategy to guide treatment. Further research should use better methodology to study p...
Source: Critical Care Clinics - May 12, 2020 Category: Intensive Care Authors: Thomas Moumneh, Philip S. Wells, Sebastien Miranda Source Type: research

Supportive Therapy
This article reviews the growing body of literature regarding ECMO support of acute high-risk PE. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 12, 2020 Category: Intensive Care Authors: Vanessa M. Bazan, Peter Rodgers-Fischl, Joseph B. Zwischenberger Source Type: research

Intensive Care Units as a Place to Manage Pulmonary Emboli
There was once a time when the main considerations for the acute treatment of pulmonary emboli (PE) were anticoagulation, inferior vena caval interruption, and thrombolytics. The diagnosis, risk-stratification, treatment, and follow-up of PE has become more complicated. Due to the heterogeneity of PE patients (medical, oncology, orthopedics, surgery, neurosurgery, pediatrics, and obstetrics), a variety of alternate options began to develop. The management of PE became more complex due to the expanded role of catheter-based therapies, surgical thrombectomies, and cardiac-assist technologies, such as right ventricular-assist...
Source: Critical Care Clinics - May 12, 2020 Category: Intensive Care Authors: Michael Baram, Bharat Awsare, Geno Merli Tags: Preface Source Type: research

Pulmonary Embolism in Intensive Care Unit
This article addresses the unique needs of critically ill patients with PE. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 11, 2020 Category: Intensive Care Authors: Michael Baram, Bharat Awsare, Geno Merli Source Type: research

Interventional Radiology Therapy
Endovascular management of pulmonary embolism can be divided into therapeutic and prophylactic treatments. Prophylactic treatment includes inferior vena cava filter placement, whereas endovascular therapeutic interventions include an array of catheter-directed therapies. The indications for both modalities have evolved over the last decade as new evidence has become available. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 11, 2020 Category: Intensive Care Authors: David M. Ruohoniemi, Akhilesh K. Sista Source Type: research

Surgical Pulmonary Embolectomy
This article provides insight on the history, current data, and future directions of surgical pulmonary embolectomy. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 11, 2020 Category: Intensive Care Authors: Dale Shelton Deas, Brent Keeling Source Type: research

Pulmonary Embolism in the Intensive Care Unit: Therapy in Subpopulations
The optimal management of a submassive or massive pulmonary embolism (PE) during pregnancy is unclear because of a lack of large clinical trials. Evaluation of the patient who may be a candidate for more aggressive therapy includes the use of biomarkers and echocardiogram for risk stratification. PE Response teams (PERTs) have gained increasing acceptance by the medical community and are being implemented in hospitals in the United States and worldwide. PERTs bring together a team of specialists from different disciplines to enhance decision-making in the patient with acute submassive and massive PE. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 11, 2020 Category: Intensive Care Authors: John R. Bartholomew Source Type: research

Post-Intensive Care Unit Follow-up of Pulmonary Embolism
This article discusses the recommended duration of intensive care unit stay after high-intermediate risk or high-risk pulmonary embolism, duration of anticoagulation after venous thromboembolism event, retrieval of inferior vena cava filters, post-hospitalization follow-up and assessment of right ventricular function, and assessment for chronic thromboembolic pulmonary hypertension, chronic thromboembolic disease, and post –pulmonary embolism syndrome. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 11, 2020 Category: Intensive Care Authors: Sonia Jasuja, Richard N. Channick Source Type: research

Overview of Management of Intermediate- and High-Risk Pulmonary Embolism
Anticoagulation is the cornerstone of acute pulmonary embolism (PE) therapy. Intermediate-risk (submassive) or high-risk (massive) PE patients have higher mortality than low-risk patients. It is generally accepted that high-risk PE patients should be considered for more aggressive therapy. Intermediate-risk patients can be subdivided, although more than simply categorizing the patient is required to guide therapy. Therapeutic approaches depend on a prompt, detailed evaluation, and PE response teams may help with rapid assessment and initiation of therapy. More clinical trial data are needed to guide clinicians in the manag...
Source: Critical Care Clinics - May 7, 2020 Category: Intensive Care Authors: Victor F. Tapson, Aaron S. Weinberg Source Type: research

Special Considerations in Pulmonary Embolism
This article describes 2 relatively rare, but complex situations in pulmonary embolism (PE): clot-in-transit (CIT), incidental PE (IPE). CIT describes a venous thromboembolism that has become lodged in the right heart. CIT is associated with high mortality and presents unique challenges in management. Incidental PE (IPE) describes PE diagnosed on imaging performed for another indication. The treatment is complex because there is often a disconnect between the PE severity on imaging and lack of severity of the clinical presentation. We summarize the available literature and aid clinicians as they manage patients with PE acr...
Source: Critical Care Clinics - May 7, 2020 Category: Intensive Care Authors: Christopher Kabrhel, Rachel Rosovsky, Shannon Garvey Source Type: research

Management of Right Ventricular Failure in Pulmonary Embolism
This article reviews the pathophysiology behind acute right ventricular failure and strategies for managing right ventricular failure in acute PE. Immediate clot reduction via systemic thrombolytics, catheter procedures, or surgery is always advocated for unstable patients. While waiting to mobilize these resources, it often becomes necessary to start resuscitation and vasoactive medications. Clinicians should carefully assess volume status and judiciously resuscitate, avoiding volume overloading the acutely dilated right ventricle. Right ventricular assist devices may have an expanding role in the future. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 1, 2020 Category: Intensive Care Authors: Steven Zhao, Oren Friedman Source Type: research

Nitric Oxide and Endothelial Dysfunction
This article reviews mechanisms governing nitric oxide production and downstream effects, highlighting the role of nitric oxide signaling in organ system pathologies. (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Authors: Anthony R. Cyr, Lauren V. Huckaby, Sruti S. Shiva, Brian S. Zuckerbraun Source Type: research

Thrombocytopenia-Associated Multiple Organ Failure
Thrombocytopenia-associated multiple organ failure is a clinical phenotype encompassing a spectrum of syndromes associated with disseminated microvascular thromboses. Autopsies performed in patients that died with thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, or disseminated intravascular coagulation reveal specific findings that can differentiate these 3 entities. Significant advancements have been made in our understanding of the pathologic mechanisms of these syndromes. Von Willebrand factor and ADAMTS-13 play a central role in thrombotic thrombocytopenic purpura. Shiga toxins and the complement pathwa...
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Authors: Trung C. Nguyen Source Type: research

Toward a Better Mechanistic Understanding of Critical Illness: Endothelial, Microvascular and Coagulation Dysfunction
Few physiologic processes are closer to the “heart and soul” of critical care practice as tissue perfusion. Matching oxygen delivery to metabolic demand is arguably the quintessential physiologic essence of the practice of critical care medicine and one of the central daily struggles of every intensivist. It is no surprise that a deep und erstanding of how the cardiovascular system functions and how its components articulate to achieve efficient perfusion and oxygen delivery is central to the craft of the practicing clinician caring for the critically ill. (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Authors: Hernando Gomez Danies, Joseph A. Carcillo Tags: Preface Source Type: research

Coagulation/Endothelial Dysfunction
CRITICAL CARE CLINICS (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Authors: Hernando Gomez Danies, Joseph A. Carcillo Source Type: research

Copyright
ELSEVIER (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Source Type: research

Contributors
JOHN A. KELLUM, MD, MCCM (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Source Type: research

Contents
Hernando Gomez Danies and Joseph A. Carcillo (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Source Type: research

Forthcoming Issues
Pulmonary Embolism in the ICU (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Source Type: research

Red Blood Cell Dysfunction in Critical Illness
This article reviews red blood cell (RBC) physiology and dysfunction relevant to disordered O2 delivery in the critically ill. Flow is the focus of O2 delivery regulation: O2 content is relatively fixed, whereas flow fluctuates greatly. Thus, blood flow volume and distribution vary to maintain coupling between O2 delivery and demand. This article reviews conventional RBC physiology influencing O2 delivery and introduces a paradigm for O2 delivery homeostasis based on coordinated gas transport and vascular signaling by RBCs. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 11, 2020 Category: Intensive Care Authors: Stephen Rogers, Allan Doctor Source Type: research

A Review on Microvascular Hemodynamics
The microcirculation is a complex network of vessels ranging from as large as 100  μm to as small as 5 μm. This complex network is responsible for the regulation of oxygen to the surrounding tissues and ensures metabolite washout. With a more complete understanding of the microcirculation’s physiologic and pathologic tendencies, engineers can create new solutions to combat blood pathologies and shock-related diseases. Over the last number of decades a grown interest in the microcirculation has resulted in the development of fundamental techniques to quantify the microvasculature flow and the release o...
Source: Critical Care Clinics - February 10, 2020 Category: Intensive Care Authors: Carlos J. Munoz, Alfredo Lucas, Alexander T. Williams, Pedro Cabrales Source Type: research

Thrombotic Thrombocytopenic Purpura, Heparin-Induced Thrombocytopenia, and Disseminated Intravascular Coagulation
Hemostatic abnormalities are common among critically ill patients and are associated with a high risk of bleeding. The abnormalities range from isolated thrombocytopenia or prolongation of global coagulation assays to complex disease states, such as thrombotic microangiopathic syndromes, and can be associated with a wide range of conditions, including trauma, surgery, acute disease processes, cardiopulmonary bypass, and exposure to drugs and blood products. Prompt identification of underlying causes is important because treatment strategies vary. Moreover, prompt initiation of both supportive and specific treatments is vit...
Source: Critical Care Clinics - February 6, 2020 Category: Intensive Care Authors: Ram Kalpatthi, Joseph E. Kiss Source Type: research

Endothelial Glycocalyx
The endothelial glycocalyx (EG) is the most luminal layer of the blood vessel, growing on and within the vascular wall. Shedding of the EG plays a central role in many critical illnesses. Degradation of the EG is associated with increased morbidity and mortality. Certain illnesses and iatrogenic interventions can cause degradation of the EG. It is not known whether restitution of the EG promotes the survival of the patient. First trials that focus on the reorganization and/or restitution of the EG seem promising. Nevertheless, the step “from bench to bedside” is still a big one. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 6, 2020 Category: Intensive Care Authors: Jan Jedlicka, Bernhard F. Becker, Daniel Chappell Source Type: research

Platelet Activation and Endothelial Cell Dysfunction
This article discusses the pathways wherein inflammation regulates platelet and endothelial cell function. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 5, 2020 Category: Intensive Care Authors: Tom van der Poll, Robert I. Parker Source Type: research

Coagulation Disorders in Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome
Hemophagocytic lymphohistiocytosis (HLH) is a rare and severe condition that can lead patients to the intensive care unit. HLH diagnosis may be challenging, as it relies on sets of aspecific criteria. Several organ dysfunctions have been described during HLH, including hemostasis impairment found in more than half of the patients. The most frequently reported anomaly is a decrease in the fibrinogen level, which has been associated with higher mortality rates. Coagulation impairment study in patients with HLH represents an interesting field of research, as little is known about the mechanism leading to hypofibrinogenemia. (...
Source: Critical Care Clinics - February 3, 2020 Category: Intensive Care Authors: Sandrine Valade, Eric Mariotte, Elie Azoulay Source Type: research

Typical and Atypical Hemolytic Uremic Syndrome in the Critically Ill
Hemolytic uremic syndrome is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome have a similar clinical presentation. Diagnostic needs to be prompt to decrease mortality, because identifying the different disorders can help to tailor specific, effective therapies. However, diagnosis is challenging and morbidity and mortality remain high, especially in the critically ill population. Development of clinical prediction scores and rapid diagnostic tests for hemolytic uremic synd...
Source: Critical Care Clinics - January 31, 2020 Category: Intensive Care Authors: Carlos L. Manrique-Caballero, Sadudee Peerapornratana, Cassandra Formeck, Gaspar Del Rio-Pertuz, Hernando Gomez, John A. Kellum Source Type: research

Role of Antithrombin III and Tissue Factor Pathway in the Pathogenesis of Sepsis
The pathobiology of the septic process includes a complex interrelationship between inflammation and the coagulations system. Antithrombin (AT) and tissue factor are important components of the coagulation system and have potential roles in the production and amplification of sepsis. Sepsis is associated with a decrease in AT levels, and low levels are also associated with the development of multiple organ failure and death. Treatment strategies incorporating AT replacement therapy in sepsis and septic shock have not resulted in an improvement in survival or reversal of disseminated intravascular coagulation. (Source: Critical Care Clinics)
Source: Critical Care Clinics - January 31, 2020 Category: Intensive Care Authors: Sarah Sungurlu, Jessica Kuppy, Robert A. Balk Source Type: research

The Angiopoietin-Tie2 Pathway in Critical Illness
Lethal features of sepsis and acute respiratory distress syndrome (ARDS) relate to the health of small blood vessels. For example, alveolar infiltration with proteinaceous fluid is often driven by breach of the microvascular barrier. Spontaneous thrombus formation within inflamed microvessels exacerbates organ ischemia, and in its final stages, erupts into overt disseminated intravascular coagulation. Disruption of an endothelial signaling axis, the Angiopoietin-Tie2 pathway, may mediate the abrupt transition from microvascular integrity to pathologic disruption. This review summarizes preclinical and clinical results that...
Source: Critical Care Clinics - January 31, 2020 Category: Intensive Care Authors: Kelsey D. Sack, John A. Kellum, Samir M. Parikh Source Type: research

Cell-Cell Communication Breakdown and Endothelial Dysfunction
Guided by organ-specific signals in both development and disease response, the heterogeneous endothelial cell population is a dynamic member of the vasculature. Functioning as the gatekeeper to fluid, inflammatory cells, oxygen, and nutrients, endothelial cell communication with its local environment is critical. Impairment of endothelial cell-cell communication not only disrupts this signaling process, but also contributes to pathologic disease progression. Expanding our understanding of those processes that mediate endothelial cell-cell communication is an important step in the approach to treatment of disease processes....
Source: Critical Care Clinics - January 30, 2020 Category: Intensive Care Authors: Daniel D. Lee, Margaret A. Schwarz Source Type: research

Immune Consequences of Endothelial Cells ’ Activation and Dysfunction During Sepsis
The vascular endothelium provides a direct interface between circulating blood cells and parenchymal cells. Thus, it has a key role in vasomotor tone regulation, primary hemostasis, vascular barrier, and immunity. In the case of systemic inflammation, endothelial cell (EC) activation initiates a powerful innate immune response to eliminate the pathogen. In some specific conditions, ECs may also contribute to the activation of adaptive immunity and the recruitment of antigen-specific lymphocytes. However, the loss of EC functions or an exaggerated activation of ECs during sepsis can lead to multiorgan failure. (Source: Critical Care Clinics)
Source: Critical Care Clinics - January 29, 2020 Category: Intensive Care Authors: St éphanie Pons, Marine Arnaud, Maud Loiselle, Eden Arrii, Elie Azoulay, Lara Zafrani Source Type: research

The Inflammatory and Hemostatic Response in Sepsis and Meningococcemia
This article reviews the pathogenesis of sepsis, in particular the inflammatory and hemostatic response in meningococcal sepsis. (Source: Critical Care Clinics)
Source: Critical Care Clinics - January 29, 2020 Category: Intensive Care Authors: Navin P. Boeddha, Thomas Bycroft, Simon Nadel, Jan A. Hazelzet Source Type: research

Microvascular Dysfunction in the Critically Ill
Microvascular dysfunction is a frequent complication of many chronic and acute conditions, especially in the critically ill. Moreover, the severity of microvascular alterations is associated with development of organ dysfunction and poor outcome. The complexities and heterogeneity of critical illness, especially in the elderly patient, requires more mechanistically oriented clinical trials that monitor the effectiveness of existing therapies and of those to come. Recent advances in the ability to obtain physiologically based assessments of microcirculatory function at the bedside will make microcirculatory-guided resuscita...
Source: Critical Care Clinics - January 22, 2020 Category: Intensive Care Authors: Can Ince, Daniel De Backer, Philip R. Mayeux Source Type: research

Biomarker Panels in Critical Care
This article discusses the discovery and validation of biomarker panels, along with their translation to the clinical setting. The current literature on the use of biomarker panels in sepsis, acute respiratory distress syndrome, and acute kidney injury is reviewed (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Authors: Susan R. Conway, Hector R. Wong Source Type: research

Metabolomics and the Microbiome as Biomarkers in Sepsis
Metabolomics is an emerging field of research interest in sepsis. Metabolomics provides new ways of exploring the diagnosis, mechanism, and prognosis of sepsis. Advancements in technologies have enabled significant improvements in identifying novel biomarkers associated with the disease progress of sepsis. The use of metabolomics in the critically ill may provide new approaches to enable precision medicine. Furthermore, the dynamic interactions of the host and its microbiome can lead to further progression of sepsis. Understanding these interactions and the changes in the host ’s genomics and the microbiome can provi...
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Authors: Jisoo Lee, Debasree Banerjee Source Type: research

The Role of Biomarkers in Acute Kidney Injury
Several biomarkers have been developed to detect acute kidney injury (AKI) and predict outcomes. Most AKI biomarkers have been shown to be expressed before serum creatinine and to be more sensitive and specific than urine output. Only a few studies have examined how implementation can change clinical outcomes. A second generation of AKI biomarkers have been developed. These markers, including tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulinlike growth factor –binding protein 7 (IGFBP7), have obtained regulatory approval in many countries based on large, rigorous clinical studies and small, single-centere...
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Authors: Nattachai Srisawat, John A. Kellum Source Type: research

Biomarkers of Immunosuppression
It is now recognized that sepsis is not a uniformly proinflammatory state. There is a well-recognized counter anti-inflammatory response that occurs in many patients. The timing and magnitude of this response varies considerably and thus makes its identification and manipulation more difficult. Studies in animals and humans have now identified a small number of biologic responses that characterize this immunosuppressed state, such as lymphocyte death, HLA receptor downregulation, and monocyte exhaustion. Researchers are now trying to use these as markers of individual immunosuppression to predict outcomes and identify pati...
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Authors: Abinav K. Misra, Mitchell M. Levy, Nicholas S. Ward Source Type: research

The Future of Biomarkers
Numerous compounds have been tested as potential biomarkers for multiple possible applications within intensive care medicine but none is or will ever be sufficiently specific or sensitive for the heterogeneous syndromes of critical illness. New technology and access to huge patient databases are providing new biomarker options and the focus is shifting to combinations of several or multiple biomarkers rather than the single markers that research has concentrated on in the past. Biomarkers will increasingly be used as part of routine clinical practice in the future, complementing clinical examination and physician expertis...
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Authors: Jean-Louis Vincent, Elisa Bogossian, Marco Menozzi Source Type: research

Preface
Prompt diagnosis and early intervention are now recognized as an essential factor in survival of critical illness. This is certainly true for both sepsis and acute respiratory distress syndrome, the two most common disease states with which we are faced in critical care. We last edited an issue of Critical Care Clinics on “Biomarkers in the Critically Ill Patient” in 2011. It would be great if I were able to report that, over the past 9 to 10 years, we have made remarkable progress in the field and can now use biomarkers for early diagnosis, precision targeting for guiding the use of new therapeutic agents, inc...
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Authors: Mitchell M. Levy Source Type: research

Biomarkers in Critical Care
CRITICAL CARE CLINICS (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Authors: Mitchell M. Levy Source Type: research

Copyright
ELSEVIER (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Source Type: research

Contributors
JOHN A. KELLUM, MD, MCCM (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Source Type: research

Contents
Mitchell M. Levy (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Source Type: research

Forthcoming Issues
Coagulation/Endothelial Dysfunction (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 14, 2019 Category: Intensive Care Source Type: research