Current opinion in critical care
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Curr Opin Crit Care · Oct 2013
ReviewConservative initiation of antimicrobial treatment in ICU patients with suspected ICU-acquired infection: more haste less speed.
To review the recent literature supporting the idea that in some patients suspected of having a new ICU-acquired infection, antibiotics can be withheld until evidence to confirm diagnosis is obtained. ⋯ In the ICU, patients without septic shock but suspected of having an ICU-acquired infection may be able to have antibiotics withheld until infection is confirmed using a combination of laboratory, radiologic, and microbiological data.
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Curr Opin Crit Care · Oct 2013
ReviewNovelties in biomarkers for the management of circulatory failure.
The purpose of the present work was to review the literature on the role of biomarkers for the diagnosis, the risk stratification, and the management of circulatory failure. ⋯ Because of the tight association between circulatory and renal failure, we put a special emphasis on cardiovascular [B-type natriuretic peptide (BNP), Nt-proBNP, troponin, QSOX-1, sST-2, mid-regional pro-atrial natriuretic peptide] and renal biomarkers (neutrophil gelatinase-associated lipocalin, cystatin C, liver-type fatty acid-binding protein, kidney injury molecule-1, insulin-like growth factor-binding protein-7, tissue inhibitor of metalloproteinase-2). We also discuss nonspecific biomarkers (pro-ADM, glycemia, MicroRNA, chromogramin A) in this setting. We discuss the potential interest and limits, from diagnosis to prognosis reclassification, of cutting-edge new biomarkers, but also widely available and inexpensive biomarkers, in the particular setting of circulatory failure.
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Curr Opin Crit Care · Oct 2013
ReviewNovelties in pharmacological management of cardiopulmonary resuscitation.
The ultimate goal of cardiopulmonary resuscitation is long-term neurologically intact survival. Despite numerous well-designed studies, the medications currently used in advanced cardiac life support have not demonstrated success in this regard. This review describes the novel therapeutics under investigation to improve functional recovery and survival. ⋯ Although substantial data have shown benefits using robust animal models, further human studies are necessary to investigate the potential long-term benefits of these therapies.
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Influenza pandemics occur intermittently and represent an existential global infectious diseases threat. The purpose of this review is to describe clinical and research preparedness for future pandemics. ⋯ Better planning is necessary to optimize both clinical and research responses to future pandemics.