Critical Care Alert – June 1, 2010
June 1, 2010
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Which Vasopressor Is Best in Patients with Shock?
Consensus guidelines recommend the use of either dopamine or norepinephrine as first-line therapy for patients with shock, but recent observational evidence suggests norepinephrine may be associated with better outcomes. -
Reducing Pain on Chest Tube Removal
Casey and colleagues compared the effects on pain, level of consciousness, and vital signs of 2 different doses of remifentanil and placebo for removal of chest drains after cardiac surgery in 60 patients. -
Dead Space Fraction as a Prognosticator in ARDS
Raurich and colleagues studied 80 patients with acute respiratory distress syndrome (ARDS) to determine whether the alveolar dead-space fraction (VD/VT, the proportion of each breath that does not participate in gas exchange) was a predictor of ultimate survival. The patients were ages 18 years or older, acutely ill in the investigators' ICU, and met the current international diagnostic criteria for ARDS. -
Daily Reminders and Earlier Removal of Central Venous and Urinary Catheters
This study from a surgical ICU in a french university hospital sought to determine the effect on catheterization duration of a daily reminder notifying physicians that the patient had a central venous catheter (CVC) or urinary tract catheter (UTC) and asking whether there was continued need for that catheter. -
Special Feature: Less Invasive Hemodynamic Monitoring
Intensive care practitioners are constantly faced with questions about their patients' hemodynamic issues, including the volume status, fluid responsiveness, and the need for vasopressors or inotropic support. -
Pharmacology Watch: Atypical Fractures and Bisphosphonate Therapy
In this issue: Fractures and bisphosphonate therapy, warfarin anticoagulation and influenza vaccine and cotrimoxazole, antiplatelet therapy with clopidogrel and aspirin, FDA Actions. -
Clinical Briefs in Primary Care supplement