Bilateral absence of N20 responses in the setting of therapeutic hypothermia does not preclude neurologic recovery in comatose survivors of cardiac arrest.
The presence of cerebral complications of infective endocarditis (IE) can affect diagnostic and treatment decisions. Thus, this group from Paris, France, evaluated whether early cerebral MRI would affect the diagnosis and management of hospitalized patients suspected of having IE.
In this before-after study in a surgical ICU, addition to the daily physician worksheet of a red box requiring the checking of "yes" or "no" to continued need for central venous and urinary catheters was associated with a significant reduction in the duration of catheterization.
Getting stuck with a needle is frightening. Most health care workers are frightened and imagine they will become HIV positive. When prophylaxis is indicated, it needs to be started as soon as possible, so it falls to the ED provider to determine the risk and start the right medications to prevent the development of disease.
Terragni et al performed this 4-year-long multicenter randomized controlled trial to determine whether early (6-8 days) vs late (13-15 days) tracheotomy would reduce ventilator-associated pneumonia (VAP) incidence.
Patients with neuromuscular disease who are intubated and subsequently fail multiple spontaneous breathing trials are often relegated to placement of a tracheo-stomy and continuous mechanical ventilation.
