Electrical impedance tomography in the adult intensive care unit: clinical applications and future directions
Purpose of review
Electrical impedance tomography (EIT) is a novel, noninvasive, radiation-free, bedside imaging and monitoring tool to assess and visualize regional distribution of lung ventilation and perfusion. Although primarily a research tool, rapidly emerging data are beginning to define its clinical role, and it is poised to become a ubiquitous addition to the arsenal of the intensive care unit (ICU). In this review, we summarize the data supporting clinical use of EIT in adult ICUs, with an emphasis on appropriate application while highlighting future directions.
Recent findings
Recent major studies hav...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY MONITORING: Edited by Jeanine P. Wiener-Kronish Source Type: research
Editorial: Monitoring patients in the ICU in 2022
No abstract available (Source: Current Opinion in Critical Care)
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY MONITORING: Edited by Jeanine P. Wiener-Kronish Source Type: research
Resuscitation guideline highlights
Purpose of review
The purpose of this review was to give an overview of the most significant updates in resuscitation guidelines and provide some insights into the new topics being considered in upcoming reviews.
Recent findings
Recent updates to resuscitation guidelines have highlighted the importance of the earlier links in the chain-of-survival aimed to improve early recognition, early cardiopulmonary resuscitation (CPR) and defibrillation. Empowering lay rescuers with the support of emergency medical dispatchers or telecommunicators and engaging the community through dispatching volunteers and Automated Exte...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest - who, when, and where?
Purpose of review
Extracorporeal cardiopulmonary resuscitation (ECPR) is an invasive and resource-intensive therapy used to care for patients with refractory cardiac arrest. In this review, we highlight considerations for the establishment of an ECPR system of care for patients suffering refractory out-of-hospital cardiac arrest (OHCA).
Recent findings
ECPR has been shown to improve neurologically favorable outcomes in patients with refractory cardiac arrest in numerous studies, including a single randomized control trial. Successful ECPR programs are typically part of a comprehensive system of care that optimiz...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
The future of resuscitation education
Purpose of review
The purpose of this review is to provide an update for critical care clinicians and providers on the recent developments in patient and healthcare professional (HCP) resuscitation education.
Recent findings
The family members of patients at high-risk of cardiac arrest need to be provided with access to basic life support (BLS) training. Many low-cost methods are now available to provide BLS training beyond attending a traditional BLS instructor-led cardiopulmonary resuscitation (CPR) class. Hybrid-blended learning formats provide new opportunities to receive individualized CPR-training in a fle...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
Cardiac arrest centres: what, who, when, and where?
Purpose of review
Cardiac arrest centres (CACs) may play a key role in providing postresuscitation care, thereby improving outcomes in out-of-hospital cardiac arrest (OHCA). There is no consensus on CAC definitions or the optimal CAC transport strategy despite advances in research. This review provides an updated overview of CACs, highlighting evidence gaps and future research directions.
Recent findings
CAC definitions vary worldwide but often feature 24/7 percutaneous coronary intervention capability, targeted temperature management, neuroprognostication, intensive care, education, and research within a centra...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
Surviving cardiac arrest - what do we know about recovery & survivorship?
Purpose of review
There has been increasing interest in examining how cardiac arrest survivors and their families experience life after sudden cardiac arrest (SCA). Understanding their experiences provides a basis to study tools and interventions to improve short- and long-term recovery and rehabilitation.
Recent findings
Qualitative interview and survey-style studies explored the lived experience of SCA survivors and revealed common themes (e.g., need for recovery expectations and long-term follow-up resources). A heightened awareness for the unique needs of family and loved ones of survivors led to qualitative...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
How technology can save lives in cardiac arrest
Purpose of review
Technology is being increasingly implemented in the fields of cardiac arrest and cardiopulmonary resuscitation. In this review, we describe how recent technological advances have been implemented in the chain of survival and their impact on outcomes after cardiac arrest. Breakthrough technologies that are likely to make an impact in the future are also presented.
Recent findings
Technology is present in every link of the chain of survival, from prediction, prevention, and rapid recognition of cardiac arrest to early cardiopulmonary resuscitation and defibrillation. Mobile phone systems to notif...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
Temperature control after cardiac arrest: friend or foe
Purpose of review
Most patients who are successfully resuscitated after cardiac arrest are initially comatose and require mechanical ventilation and other organ support in an ICU. Best practice has been to cool these patients and control their temperature at a constant value in the range of 32–36 oC for at least 24 h. But the certainty of the evidence for this practice is increasingly being challenged. This review will summarize the evidence on key aspects of temperature control in comatose postcardiac arrest patients.
Recent findings
The Targeted Temperature Management 2 (TTM-2) trial documented no differ...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
Cardiac arrest and coronavirus disease 2019
Purpose of review
The impact of the coronavirus disease 2019 (COVID-19) on the cardiovascular system has been highlighted since the very first weeks after the severe acute respiratory syndrome coronavirus 2 identification. We reviewed the influence of COVID-19 pandemic on cardiac arrest, both considering those occurred out of the hospital (OHCA) and in the hospital (IHCA).
Recent findings
An increase in OHCA incidence occurred in different countries, especially in those regions most burdened by the COVID-19, as this seems to be bounded to the pandemic trend. A change of OHCA patients’ characteristics, with an ...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
Health inequities in out-of-hospital cardiac arrest
Purpose of review
Out-of-hospital cardiac arrest (OHCA) is a time-critical emergency in which a rapid response following the chain of survival is crucial to save life. Disparities in care can occur at each link in this pathway and hence produce health inequities. This review summarises the health inequities that exist for OHCA patients and suggests how they may be addressed.
Recent findings
There is international evidence that the incidence of OHCA is increased with increasing deprivation and in ethnic minorities. These groups have lower rates of bystander CPR and bystander-initiated defibrillation, which may be...
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: CARDIOPULMONARY RESUSCITATION: Edited by Gavin D. Perkins Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Critical Care)
Source: Current Opinion in Critical Care - June 1, 2022 Category: Nursing Tags: EDITORIAL INTRODUCTIONS Source Type: research
Perioperative screening and management in elective complex hepatobiliary surgery
We present an evidence-based overview of the preoperative screening, optimization and perioperative management of patients undergoing complex HPB surgery.
Summary
Perioperative care of these fragile patients is an evidence-based dynamic process. Optimal patient management undergoing HPB surgery requires risk assessment and stratification, and meticulous attention to the correction of underlying conditions. Despite this, postoperative morbidity remains relatively high and requires a cohesive multidisciplinary approach to minimize complications. (Source: Current Opinion in Critical Care)
Source: Current Opinion in Critical Care - March 8, 2022 Category: Nursing Tags: GASTROINTESTINAL SYSTEM: Edited by Julia Wendon Source Type: research
The liver-gut-axis: initiator and responder to sepsis
Purpose of review
The ‘gut-liver axis’ is thought to play an important role in pathogenesis of sepsis. Despite a wealth of experimental data to support the concept of reciprocal crosstalk between gut and liver through bacterial translocation and shaping of the microbiome by liver-derived molecules, for example bile acids, clinical data, and in particular diagnostic and therapeutic options, are limited.
Recent findings
Assessment of organ failure in the current definition of sepsis is operationalized by means of the Sequential Organ Failure Assessment (SOFA) score, including exclusively bilirubin to reflect t...
Source: Current Opinion in Critical Care - March 8, 2022 Category: Nursing Tags: GASTROINTESTINAL SYSTEM: Edited by Julia Wendon Source Type: research
Immunosuppressive drugs and associated complications in abdominal organ transplantation
Purpose of review
Intensive care management of patients who have undergone organ transplantation of liver, small bowel, pancreas, and/or kidney requires a basic knowledge of immunosuppression principles and the management of immunosuppressive medications. This review highlights the core principles of immunosuppression management in abdominal organ transplantation with a focus on complications arising from immunosuppressive drugs, both in the immediate postoperative period and in long-term usage.
Recent findings
The general principles of management of immunosuppression in the abdominal organ transplant population...
Source: Current Opinion in Critical Care - March 8, 2022 Category: Nursing Tags: GASTROINTESTINAL SYSTEM: Edited by Julia Wendon Source Type: research
