An updated meta-analysis incorporating nine randomized trials ( = 816) investigating low-to-moderate dose prolonged glucocorticoid treatment in acute respiratory distress syndrome (ARDS) show moderate-to-high quality evidence that glucocorticoid therapy is safe and reduces (i) time to endotracheal extubation, (ii) duration of hospitalization, and (iii) mortality (number to treat to save one life = 7), and increases the number of days free from (i) mechanical ventilation, (ii) intensive care unit stay, and (iii) hospitalization. Recent guideline suggests administering methylprednisolone in patients with early moderate-to-severe (1 mg/kg/day) and late persistent (2 mg/kg/day) ARDS (conditional recommendation based on moderate quality of evidence).
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http://dx.doi.org/10.1186/s40560-018-0321-9 | DOI Listing |
J Intensive Med
January 2025
Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona - SGR 911- Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain.
Aminoglycosides are concentration-dependent antibiotics exerting a bactericidal effect when concentrations at the site of infection are equal to or greater than 5 times the minimum inhibitory concentrations (MIC). When administered intravenously, they exhibit poor lung penetration and high systemic renal and ototoxicity, imposing to restrict their administration to 5 days. Experimental studies conducted in anesthetized and mechanically ventilated sheep and pigs provide evidence that high doses of nebulized aminoglycosides induce a rapid and potent bacterial killing in the infected lung parenchyma.
View Article and Find Full Text PDFCureus
December 2024
Department of Rehabilitation Medicine, School of Medicine, Showa University, Tokyo, JPN.
Tetanus is a rare but life-threatening neurological disorder caused by neurotoxins produced by . Although mortality rates have significantly decreased with modern intensive care, severe cases remain challenging due to prolonged Intensive Care Unit (ICU) stays, complications, and rehabilitation barriers. We report the case of an 81-year-old male with a history of hypertension and femoral neck fracture who developed severe tetanus following a contaminated forehead laceration.
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December 2024
Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Extreme prematurity involves a series of complications that a multidisciplinary team should manage. Taking into account the risks related to premature newborns, such as maternal-fetal infections, intrauterine growth restriction, and certain comorbidities associated with young gestational age, our objective is to highlight the importance of a multidisciplinary team in approaching cases with an unfavorable prognosis. This is a case report of an extremely preterm newborn who came from a high-risk pregnancy and needed long-term hospitalization in the Neonatal Intensive Care Unit (NICU) and mechanical ventilation.
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December 2024
Internal Medicine, Kütahya University of Health Sciences, Kütahya, TUR.
Objective: The mortality risk for critically ill patients in the intensive care unit (ICU) can be predicted through clinical assessments and laboratory test results. The accurate utilization of these parameters is essential for timely intervention and the initiation of appropriate therapeutic strategies. This study aims to retrospectively examine the relationship between patients' clinical status at ICU admission, prognostic risk scoring systems, biochemical and hematological parameters, and mortality outcomes.
View Article and Find Full Text PDFWorld J Hepatol
January 2025
Department of Medicine & Pharmacology, Texas A & M University, College Station, TX 77843, United States.
Background: Necrotizing fasciitis (NF) is a potentially fatal bacterial infection of the soft tissues. Liver cirrhosis appears to be a contributing factor to higher morbidity and mortality in patients with NF. This research article explores the relationship between these two conditions.
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