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Full-Text Articles in Critical Care
Evaluation Of An Elevated Vte Thromboprophylaxis Guideline For Critically Ill Patients Infected With Covid-19, Tony Nguyen, Heidi Clarke
Evaluation Of An Elevated Vte Thromboprophylaxis Guideline For Critically Ill Patients Infected With Covid-19, Tony Nguyen, Heidi Clarke
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Retrospective studies and systematic-review meta-analysis have shown an association in inducing a prothrombotic state in patients infected with COVID-19. The risk of VTE are compounded in the critically ill. Current practices at Baptist Hospital of Miami (BHM) is to routinely order standard prophylactic dosed chemical thromboprophylaxis for all patients infected with COVID-19. In August 2020 an anticoagulation guidance document was approved to tailor anticoagulation dosing for critically ill COVID-19 patients. At risk patients were based on clinical and laboratory markers such as D-dimer, CRP, and ferritin. Following implementation, our analysis show a statistically significant reduction in the number of treatment …
Evaluating The Association Between Vasopressin Use And In-Hospital Mortality In Patients With Septic Shock, Michael Pasqualicchio, Heidi Clarke, Jonathan Kline, Payal Patel
Evaluating The Association Between Vasopressin Use And In-Hospital Mortality In Patients With Septic Shock, Michael Pasqualicchio, Heidi Clarke, Jonathan Kline, Payal Patel
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Purpose/Background: The Surviving Sepsis Campaign recommends norepinephrine as the first-line vasopressor in patients with septic shock to maintain a mean arterial pressure (MAP) of at least 65 mmHg. The guideline also makes a weak recommendation (2B) to use vasopressin as an adjuvant therapy to raise MAP to goal or to reduce the norepinephrine rate required to maintain the goal MAP. The recommendation is based on conflicting results of the VASST trial that showed no significant difference in 28-day all-cause mortality between patients managed with norepinephrine alone compared to norepinephrine and vasopressin. However, in subgroup analysis, the VASST trial showed mortality …
Transition From Fixed-Dosing To Symptom-Triggered Management Of Alcohol Withdrawal Syndrome In The Intensive Care Unit Of A Community Hospital, Marianela Robainas, Heidi Clarke, Claudia Chang, Frances Ordieres Gonzalez, Lorenzo Porras Jr.
Transition From Fixed-Dosing To Symptom-Triggered Management Of Alcohol Withdrawal Syndrome In The Intensive Care Unit Of A Community Hospital, Marianela Robainas, Heidi Clarke, Claudia Chang, Frances Ordieres Gonzalez, Lorenzo Porras Jr.
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Background/Purpose: In the United States, 2 to 7% of heavy alcohol users admitted to the hospital for general medical care will develop severe alcohol withdrawal (AW) requiring treatment. The most dangerous complications of AW are delirium tremens and seizures. Benzodiazepines (BZD) are considered first-line therapy, with varying modality options available to providers. Fixed-dosing has historically been used to manage AW. However, studies suggest that symptom-triggered therapy (STT) can decrease length of stay and BZD duration of therapy. The purpose of this study was to evaluate the current fixed-dose protocol and outline the transition to STT in the intensive care unit …
Evaluating Antipsychotic Prescribing In The Intensive Care Unit And Across The Continuum Of Care, Michael Pasqualicchio, Heidi Clarke
Evaluating Antipsychotic Prescribing In The Intensive Care Unit And Across The Continuum Of Care, Michael Pasqualicchio, Heidi Clarke
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Purpose/Background: The 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (PADIS) recommend against both typical and atypical antipsychotic use for delirium in critically ill patients. This recommendation is based on evidence showing that these medications are not associated with shorter durations of delirium, mechanical ventilation, intensive care unit (ICU) length of stay, or reduced mortality. There are many long term complications associated with the use of antipsychotics including QTc prolongation, extrapyramidal symptoms, metabolic abnormalities, and anticholinergic effects. Regardless, antipsychotics remain the most common medication used …
National Institutes Of Health Stroke Scale (Nihss) And Tissue Plasminogen (Tpa) Education For All Critical Care Nurses, Cheriese Rawlins
National Institutes Of Health Stroke Scale (Nihss) And Tissue Plasminogen (Tpa) Education For All Critical Care Nurses, Cheriese Rawlins
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No abstract provided.