Current opinion in critical care
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To provide an evidence-based approach to improve first pass success in tracheal intubation while maintaining patient safety in the critically ill. ⋯ Recognizing the challenges and using the appropriate interventions to improve first pass tracheal intubation success, while maintaining patient safety are essential during tracheal intubation in critically ill patients. This review will provide recommendations based on the current evidence, various guidelines and expert opinion in the field. Further research will help us better understand the best strategies to improve patient outcomes.
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This article provides an overview of protein biomarkers for acute respiratory distress syndrome (ARDS) and their potential use in future clinical trials. ⋯ This article summarizes the current research on ARDS biomarkers and provides insights into how they should be integrated as prognostic and predictive enrichment tools in future clinical trials.
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Curr Opin Crit Care · Feb 2021
ReviewEmerging cellular and pharmacologic therapies for acute respiratory distress syndrome.
Advances in our understanding of the pathophysiology and biology of ARDS has identified a number of promising cellular and pharmacological therapies. These emerging therapeutics can modulate the immune response, reduce epithelial injury, target endothelial and vascular dysfunction, have anticoagulant effects, and enhance ARDS resolution. ⋯ Mesenchymal stromal cells, steroids, statins, vitamins, anticoagulants, interferons and carbon monoxide have therapeutic promise for ARDS. Identifying ARDS sub-populations most likely to benefit from targeted therapies may facilitate future advances.
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A growing evidence shows that injurious spontaneous breathing, either too weak or too strong, may injure lung and diaphragm. The purpose of review is to understand why we need monitoring for safe spontaneous breathing, and to know the target value of each monitoring to preserve safe spontaneous breathing during assisted ventilation. ⋯ We summarize why we need monitoring for safe spontaneous breathing during assisted ventilation and what the target value of each monitoring is to facilitate 'safe' spontaneous breathing during assisted ventilation.
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Curr Opin Crit Care · Feb 2021
ReviewNoninvasive ventilation and high-flow nasal oxygen for acute respiratory failure: is less more?
High-flow nasal oxygen and noninvasive ventilation (NIV) are two strategies representing an alternative to standard oxygen in the management of respiratory failure. ⋯ New large-scale clinical trials are needed to compare high-flow nasal oxygen with standard oxygen in patients with de-novo acute respiratory failure to determine the reference treatment. After which, more protective NIV could be assessed among the more severe patients.