Aerosolization of COVID-19 and Contamination Risks During Respiratory Treatments.

Background: Aerosolized medications are frequently administered across the health care continuum to acutely ill patients. During viral pandemics, the World Health Organization and the Centers for Disease Control and Prevention advise the application of airborne precautions when performing aerosol-generating medical procedures, such as aerosolized medications.

Observations: Appropriate personal protective equipment (PPE), including fit-tested particulate respirators should be worn when administering nebulized medications to patients.

Models of Peer Support to Remediate Post-Intensive Care Syndrome: A Report Developed by the Society of Critical Care Medicine Thrive International Peer Support Collaborative.

Objectives: Patients and caregivers can experience a range of physical, psychologic, and cognitive problems following critical care discharge. The use of peer support has been proposed as an innovative support mechanism.

Design: We sought to identify technical, safety, and procedural aspects of existing operational models of peer support, among the Society of Critical Care Medicine Thrive Peer Support Collaborative.

Non-convulsive status epilepticus and non-convulsive seizures in neurological ICU patients.

Background: Non-convulsive seizures (NCS) or non-convulsive status epilepticus (NCSE) has been reported in 8-20 % of critically ill patient populations, and delayed diagnosis and treatment of NCSE may lead to increased mortality. This study seeks to better understand the risk factors, characteristics, and outcome of NCS/NCSE in the neurological ICU.

Methods: This is a prospective observational study, recruiting consecutive patients admitted to the adult neurological ICU with altered mental status.

Perioperative implications of the patient with autonomic dysfunction.

Purpose Of Review: The autonomic nervous system functions to control heart rate, blood pressure, respiratory rate, gastrointestinal motility, hormone release, and body temperature on a second-to-second basis. Here we summarize some of the latest literature on autonomic dysfunction, focusing primarily on the perioperative implications.

Recent Findings: The variety of autonomic dysfunction now extends to a large number of clinical conditions in which the cause or effect of the autonomic component is blurred.

Dysautonomia: perioperative implications.

Severe autonomic failure occurs in approximately 1 in 1,000 people. Such patients are remarkable for the striking and sometimes paradoxic responses they manifest to a variety of physiologic and pharmacologic stimuli. Orthostatic hypotension is often the finding most commonly noted by physicians, but a myriad of additional and less understood findings also occur.

Technical communication: An initial evaluation of a novel anesthetic scavenging interface.

Waste anesthetic gas scavenging technology has not changed appreciably in the past 30 years. Open reservoir systems entrain high volumes of room air and dilute waste gases before emission into the atmosphere. This process requires a large vacuum pump, which is both costly to install and, although efficient, operates continuously and at near-full capacity.

Diabetes insipidus associated with propofol anesthesia.

Diabetes insipidus is a clinical entity that is often seen in neurosurgical patients either during or immediately after transsphenoidal hypophysectomy. Rarely, diabetes insipidus can manifest as a new entity months later in patients who have previously had an intracranial injury or operation.

Acute dermal capillary rupture associated with noninvasive blood pressure monitoring.

We report a case of Rumpel-Leede phenomenon, or acute dermis capillary rupture, secondary to noninvasive blood pressure monitoring in a patient with type 2 diabetes mellitus. The most likely cause was increased venous pressure during cycling of the blood pressure cuff during a hypertensive state. Anesthesiologists need to be aware that acute dermal capillary rupture, although rare, can occur in patients with thrombocytopenia and/or long-standing diabetes.