What's New

Cardiovascular Drugs

    • Pulmonary hypertension can be treated with single or combination therapy employing calcium channel blockers, phosphodiesterase inhibitors, guanylate cyclase stimulators, endothelin receptor antagonists, and prostanoids.
    • Levosimendan is a calcium sensitizer used to treat cardiogenic shock and right heart failure.
    • Clevidipine is an ultra-rapid acting calcium channel blocker used for perioperative hypertension management in cardiovascular and vascular diseases, neurosurgery, and surgery for pheochromocytoma.

Mechanical Ventilation: Approaches and Special Considerations

    • Consideration for specific ventilator modes for those at risk of acute respiratory distress syndrome (ARDS)
    • The use of respiratory therapist–guided spontaneous breathing trials
    • Changes in the pattern of tracheostomy use for acute respiratory failure
    • Expanded penetrance of palliative care in those with prolonged mechanical ventilation
    • The expanded use of extracorporeal techniques for severe ARDS

Nonpulmonary Thoracic Procedures

    • Compared to open surgery, minimally invasive surgical approaches for esophagectomy have been associated with less blood loss as well as shorter length of stay at intensive care unit and the hospital.
    • Implementation of thoracic epidural analgesia for post esophagectomy pain control has been shown to result in earlier mobilization, decreased incidence of pulmonary complications, and decreased incidence of anastomotic leaks.
    • There is a decreased incidence of respiratory complications with the intraoperative use of lung protective strategies during esophagectomy.

Evaluation and Treatment of Pediatric Obesity

    • 2017 Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practive Guideline
    • 2017 NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN)

Mechanical Ventilation: Advanced Ventilation and Adjuncts

    • The use of prone positioning to improve the outcome in patients with acute respiratory distress syndrome
    • The use of neuromuscular blockade in patients with severe acute respiratory distress syndrome
    • High-flow nasal cannula therapy as a possible alternative to noninvasive positive-pressure ventilation

Evaluation and Treatment of Pediatric Obesity

    • 2017 Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practive Guideline
    • 2017 NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN)

Pancreatic and Adrenal Disorders and Considerations

    • Although diabetes mellitus is a frequent disease encountered in the intensive care unit, critically ill patients may have other reasons for glycemic dysfunction.
    • Hyperglycemia may cause multisystem dysfunction and poor outcomes, including increased in-hospital mortality. Hypoglycemia and glucose variability are both independent risk factors for increased mortality.
    • Adrenal insufficiency in critically ill patients without preexisting adrenal disease is known as critical illness-related corticosteroid insufficiency.

Mechanical Ventilation: Respiratory Physiology and Conventional Ventilation

    • Berlin Modification of the definition of ARDS and PaO2/FIO2 ratio into mild (P/F < 300), moderate (P/F ratio < 200) and severe (P/F < 100)
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