Critical Care
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UK trial finds propofol remains preferred ICU sedation agent
The recent A2B trial found that neither dexmedetomidine nor clonidine are superior to propofol and may increase risks of agitation and bradycardia.
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Ketamine vs etomidate for intubation in patients who are critically ill
Commonly used for sedation for endotracheal intubation, these drugs are often selected for their favorable hemodynamic profiles.
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Bronchoscopy: An emerging role for advanced practice providers
Bronchoscopy is becoming an increasingly common skill for a growing subset of interventional pulmonary and critical care APPs.
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Procalcitonin levels may guide antibiotic duration in patients with suspected sepsis
Paul Dark, MD, PhD, said a 10% reduction in duration of antibiotic use shown in a recent study may seem small, but in the context of antibiotic stewardship, a 10% reduction is important.
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CHEST to offer first-of-its-kind certification for APPs in critical care
For APPs in the critical care setting, this certification exam will be a valuable way to validate their knowledge and competence in the ICU.
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Airway pressure release ventilation: Should it be used in the early stages of ARDS?
APRV has traditionally been viewed as a salvage therapy for patients with ARDS, but recent literature suggests that it can provide better overall lung recruitment with less sedation and more ventilator-free days.
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CMS decision positively impacts the future of home ventilation coverage
CMS recently released a decision on coverage for noninvasive ventilation devices for patients with COPD, a process that CHEST has been closely involved in.
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For the neuromuscular disease community, ventilation coverage victory doesn’t carry over
Patient advocate Spero Koulouras said he believes CMS home ventilation coverage criteria for patients with disorders such as ALS are still ambiguous enough that private insurers have interpreted them to deny and delay coverage.
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Platelet and fresh frozen plasma transfusion guidelines in critical care
New guidelines from CHEST promote a more restrictive approach to platelet and fresh frozen plasma use in the ICU in order to enhance patient safety and conserve resources.
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Capillary refill time: Advancing perfusion-targeted resuscitation in septic shock
Capillary refill time is a quick, noninvasive tool to assess perfusion and microvascular health in shock. It offers faster feedback than lactate levels and may improve resuscitation outcomes.
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Study highlights importance of lactation among many new mothers in ICU
Researcher, Kayla Kolbe, MD, said even in the face of critical illness, patients feel strongly about lactation.
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Data support early prone positioning for patients with COVID-19 on mechanical ventilation
Viren Kaul, MD, FCCP, said a recent observational study adds to the body of literature clarifying the optimal timing of prone positioning in this population.
