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An increasing number of patients with pulmonary arterial hypertension (PAH) have cardiovascular comorbidities. However, the effects of comorbidities on responses to PAH treatment are not well understood. ⋯ This post hoc analysis suggests that patients with PAH and cardiovascular comorbidities can benefit from combination therapy with inhaled or oral treprostinil.
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In response to the COVID-19 pandemic and as part of the statewide health care coalition response, the Minnesota Critical Care Working Group (CCWG), composed of interprofessional leaders from the state's nine largest health systems, was established and entrusted to plan and coordinate critical care support for Minnesota from March 2020 through July 1, 2021. ⋯ CCWG developed statewide critical care surge strategies assisting health care organization response to COVID-19 surges, providing a platform for clinical and operational activities. Collaboration, trust, and teamwork between CCWG leaders and health care organizations was essential to success and serves as a model for future events.
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Rapid assessment and treatment (RAT) calls, facilitated by Rapid Response Teams (RRTs), have become vital to the care of hospitalized patients whose conditions are deteriorating outside of the ICU in many institutions worldwide. A significant body of data has recognized the efficacy of rapid response systems (RRSs) in improving patient care; however, there is no standardized protocol that all RRSs practice. Even when the recognition of patient clinical deterioration is rapidly noted, further treatment may be delayed because of issues with clinical knowledge and communication between parties present, especially in training institutions. ⋯ Finally, we reassessed our responses to RAT calls postintervention. We found that an educational intervention improved patient outcomes and several key process measures in our RRS. This article describes the process and lessons learned from our initiative.
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Acute circulatory failure is critical in patients in the ICU. Indices derived from oxygen and CO2 metabolism (CO2-O2-derived indices) including the central venous-to-arterial CO2 difference and central venous-to-arterial CO2 difference/arteriovenous oxygen content ratio are markers for global metabolic demand and tissue hypoxia. ⋯ gov.
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The Minnesota Statewide Healthcare Coordination Center requested that the Minnesota Critical Care Working Group (CCWG) and Ethics Working Group (EWG), comprising interprofessional leaders from Minnesota's 9 largest health systems, plan and coordinate critical care operations during the COVID-19 pandemic, including the fall 2021 surge. ⋯ The CCWG collected and analyzed evidence demonstrating crisis conditions and health care professional moral distress during the fall 2021 COVID-19 surge. However, the group had a limited impact on care processes. This article analyzes the group's efforts. It includes recommendations for researchers and policy makers.