Current opinion in critical care
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Curr Opin Crit Care · Apr 2021
ReviewThe features of the typical traumatic brain injury patient in the ICU are changing: what will this mean for the intensivist?
To describe the key features and epidemiology of traumatic brain injury (TBI) and how they may be changing, with an emphasis on how this may affect care in the intensive care unit. ⋯ This review highlights the urgent need to develop more age-inclusive TBI consensus management guidelines aimed at improving short- and long-term outcomes for the large and growing TBI population. Being elderly does not necessarily portend a poor outcome, and more research is needed to better triage, guide management and prognosticate on these patients.
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Curr Opin Crit Care · Apr 2021
ReviewLung-protective ventilation and adjunctive strategies to manage respiratory failure: are they safe in the neurological patient?
The coexistence of neurological injury and respiratory failure is common in intensive care. This article provides a contemporary overview of the safety and efficacy of different strategies for mechanical ventilation and adjunctive respiratory approaches in patients with acute brain injury. ⋯ Research is needed to determine the safety, feasibility, and efficacy of LPV and adjunctive approaches for managing patients with concurrent brain injury and respiratory failure.
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Progress has been made in our understanding of gut dysfunction in critical illness. This review will outline new findings and give perspectives based on previous knowledge and concurrent advances in nutrition. ⋯ Gut dysfunction is associated with poor outcomes, but it remains uncertain whether strategies to improve gut function will influence survival and recovery.