Critical Care Alert – September 1, 2019
September 1, 2019
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Early Neuromuscular Blockade in Moderate-to-Severe Acute Respiratory Distress Syndrome
When the early use of a continuous infusion of cisatracurium was compared to contemporary supportive care for moderate-to-severe ARDS, including a light sedation target, high positive-end expiratory pressure, and conservative fluid strategy, there was no difference in 90-day mortality. Patients in the early neuromuscular blockade group more frequently experienced a severe cardiovascular event and ICU-acquired weakness by day 28.
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NOACs vs. Warfarin: What Are the Data in Patients With Traumatic Brain Injury and Intracranial Hemorrhage?
A three-year analysis of a prospectively maintained database with traumatic brain injury patients revealed that novel oral anticoagulant use is associated with increased risk of intracranial hemorrhage progression, neurosurgical intervention, and mortality.
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Acute Kidney Injury With Combination Antibiotics in the Critically Ill
In this retrospective study, a short course (24 to < 72 hours) of combination antibiotic therapy with piperacillin-tazobactam and vancomycin was not associated with an increased risk of acute kidney injury among critically ill patients when compared with other β-lactam and vancomycin combinations.
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Decision-Making Capacity in the ICU
A multicenter, one-day prevalence, prospective, observational, double-blind study in 19 ICUs revealed that the decisionmaking capacity of ICU patients was widely overestimated by all clinicians as compared with a capacity score measured by the Mini-Mental Status Examination and the Aid to Capacity Evaluation.