Critical care clinics
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Hospitals and health care systems with active critical care organizations (CCOs) that unified ICU units before the onset of the COVID-19 Pandemic were better positioned to adapt to the demands of the pandemic, due to their established standardization of care and integration of critical care within the larger structure of the hospital or health care system. CCOs should continue to make changes, based on the real experience of COVID-19 that would lead to improved care during the ongoing pandemic, and beyond.
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Critical care clinics · Jul 2022
ReviewCOVID-19 Acute Respiratory Distress Syndrome: One Pathogen, Multiple Phenotypes.
Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome arising from multiple causes with a range of clinical severity. In recent years, the potential for prognostic and predictive enrichment of clinical trials has been increased with identification of more biologically homogeneous subgroups or phenotypes within ARDS. COVID-19 ARDS also exhibits significant clinical heterogeneity despite a single causative agent. In this review the authors summarize the existing literature on COVID-19 ARDS phenotypes, including physiologic, clinical, and biological subgroups as well as the implications for improving both prognostication and precision therapy.
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Shock is a state in which the cardiovascular system fails to adequately deliver required substrates to maintain end-organ perfusion, tissue homeostasis, and cellular metabolism. Rapid recognition of shock and intervention is of utmost importance to reverse the shock state. This article reviews uncommon etiologies of shock classified in the following categories: distributive, hypovolemic, cardiogenic, and dissociative shock.
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Rhabdomyolysis is a relatively common phenomenon, and most cases do not require intensive care unit level of care. Although most common causes can be easily identified, in encephalopathic or critically ill patients, symptoms can be easily missed, as can uncommon etiologies. ⋯ As the list of potential causes is large, not every possible cause for rhabdomyolysis will be discussed. This article, however, will provide a general framework to manage any patient with this muscle disease.