Publications by authors named "C R Merchan"

Background: Delirium and agitation are common syndromes in critically ill patients. Valproic acid (VPA) has shown benefit in intensive care unit (ICU)-associated delirium and agitation, but further evaluation is needed.

Objective: The purpose of this study was to evaluate the effectiveness and safety of VPA for hyperactive delirium and agitation in critically ill adult patients.

View Article and Find Full Text PDF
Article Synopsis
  • IV digoxin loading doses for controlling atrial arrhythmias in critically ill patients lack extensive research, but a loading dose targeting a serum concentration of 0.8-1.5 ng/mL is suggested.
  • A study involving 92 patients found a median loading dose of 11 mcg/kg, resulting in a median serum concentration of 1.3 ng/mL, with 36% experiencing supratherapeutic levels.
  • The study showed that 60% of patients achieved a target heart rate of less than 110 beats per minute within 24 hours, indicating effectiveness in rate control, though further research is needed to validate these results.
View Article and Find Full Text PDF

Background And Purpose: Increased intracranial pressure due to cerebral edema is a medical emergency in which 23.4% sodium chloride (23.4% NaCl) may be a lifesaving intervention.

View Article and Find Full Text PDF

Background: Evidence supporting anticoagulation with unfractionated heparin (UFH) in patients with an intra-aortic balloon pump (IABP) to prevent limb ischaemia remains limited, while bleeding risks remain high. Monitoring heparin in this setting with anti-factor Xa (anti-Xa) is not previously described.

Objectives: The study objective is to describe the incidence of thromboembolic and bleeding events with the use of UFH in patients with an IABP utilising monitoring with both anti-Xa and activated partial thromboplastin time (aPTT).

View Article and Find Full Text PDF

Cangrelor may be used as a bridge when temporary interruption of dual antiplatelet therapy is necessary. However, the optimal dose and monitoring of cangrelor in patients remains unknown, especially in the setting of mechanical circulatory support (MCS). We conducted an observational, single-center, retrospective cohort study of patients who had percutaneous coronary intervention within 3 months and received cangrelor while admitted to any intensive care unit.

View Article and Find Full Text PDF