Canadian respiratory journal : journal of the Canadian Thoracic Society
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New-onset atrial fibrillation is a common problem in critically ill patients, with reported incidence ranging from 5% to 46%. It is associated with significant morbidity and mortality. The present review summarizes studies investigating new-onset atrial fibrillation conducted in the critical care setting, focusing on the etiology, management of the hemodynamically unstable patient, rate versus rhythm control, ischemic stroke risk and anticoagulation. Recommendations for an approach to management in the intensive care unit are drawn from the results of these studies.
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The present report describes a 48-year-old woman with a history of recurrent 'crack' cocaine use, who developed progressive shortness of breath over a period of years. Serial imaging revealed progressive interstitial fibrosis secondary to recurrent alveolar hemorrhage and inflammation from crack cocaine. The present case serves as a reminder of the numerous sequelae of crack cocaine use, highlighting one particularly severe outcome.
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Editorial Comment
Effective handover communication: Do we need more evidence?
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Observational Study
The association between obesity and outcomes in critically ill patients.
Obesity rates are increasing worldwide, particularly in North America. The impact of obesity on the outcome of critically ill patients is unclear. ⋯ Obesity was not necessarily associated with worse outcomes in critically ill patients.