Chest
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Review Meta Analysis
Impact of Right Ventricular Dysfunction on Short- and Long-Term Mortality in Sepsis: A Meta-Analysis of 1,373 Patients.
Right ventricular (RV) dysfunction in sepsis and septic shock has been infrequently studied and has uncertain prognostic significance. ⋯ In this meta-analysis of observational studies, RV dysfunction was associated with higher short-term and long-term mortality in sepsis and septic shock.
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Pulmonary nodules are a frequent, incidental finding on CT scans, ranging from up to 8.4% on abdominal scans and up to 48% on CT angiograms. Incidental findings are sometimes disregarded or overshadowed by critical situations and may not be disclosed or documented on discharge. The costs and risks associated with incidental findings are not insignificant, including the risk of a delayed diagnosis of lung cancer. ⋯ Improvements with consistent use of Fleischner guidelines in scan reports by radiologists and increased ownership in informing patients of incidental nodules by ED and trauma providers have occurred. As the frequency of chest CT imaging is increasing, the number of incidental nodules identified will also increase. A lung nodule surveillance process would greatly benefit every lung nodule clinic or hospital system for management of pulmonary nodules.
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Although clinical studies have evaluated dexmedetomidine as a strategy to improve noninvasive ventilation (NIV) comfort and tolerance in patients with acute respiratory failure (ARF), their results have not been summarized. ⋯ Compared with any sedation strategy or placebo, dexmedetomidine reduced the risk of delirium and the need for mechanical ventilation while increasing the risk of bradycardia and hypotension. The results are limited by imprecision, and further large RCTs are needed.