Articles: intensive-care-units.
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
Observational StudyPerioperative Implementation of Low-Dose Pregabalin in an Enhanced Recovery After Cardiac Surgery Protocol: A Pre-Post Observational Study.
Determine the effect of low-dose pregabalin in the perioperative enhanced recovery after cardiac surgery protocol. ⋯ In this evaluation of perioperative pregabalin administration for patients requiring cardiac surgery, pregabalin reduced postoperative opioid use, with significant reductions on postoperative day 0, and without any significant increase in adverse reactions. However, no differences in intensive care unit length of stay, time to extubation, or mortality were noted. The implementation of low-dose perioperative pregabalin within an Enhanced Recovery After Cardiac Surgery protocol may be effective at reducing postoperative opioid use in the immediate postoperative period, and may be safe with regard to adverse events. Ideal dosing strategies have not been determined; thus, further randomized control trials with an emphasis on limiting confounding factors need to be conducted.
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Chikungunya virus is an Alphavirus, it belongs to the family Togaviridae and is transmitted by mosquitoes. It was first described during an outbreak in Southern Tanzania in 1952. It generally causes a febrile syndrome, accompanied by joint pain and arthritis, which is often debilitating and may persist for months or years. ⋯ A report of detectable Chikungunya virus by real-time polymerase chain reaction in real time was received post-mortem. This case results of clinical relevance due to its atypical presentation and the country low prevalence of severe infections by this virus. It warns of the need to include the differential diagnosis in cases with suspected diagnosis.
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Intensive care medicine · Jan 2024
ReviewDiagnosis and management of autoimmune diseases in the ICU.
Autoimmune diseases encompass a broad spectrum of disorders characterized by disturbed immunoregulation leading to the development of specific autoantibodies, resulting in inflammation and multiple organ involvement. A distinction should be made between connective tissue diseases (mainly systemic lupus erythematosus, systemic scleroderma, inflammatory muscle diseases, and rheumatoid arthritis) and vasculitides (mainly small-vessel vasculitis such as antineutrophil cytoplasmic antibody-associated vasculitis and immune-complex mediated vasculitis). ⋯ Data about autoimmune diseases in the ICU are limited and there is a need for multicenter, international collaboration to improve patients' diagnosis, management, and outcomes. The objective of this narrative review is to summarize the epidemiology, clinical features, and selected management of severe systemic autoimmune diseases.