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All Topic Review Biography
Topic Review
TDM-Guided Recommendations in Septic Critically Ill Patients
Optimizing the entire therapeutic regimen in septic critically ill patients should be based not only on improving antibiotic use but also on optimizing the entire therapeutic regimen by considering possible drug–drug or drug–nutrient interactions. There are reports of endocarditis, meningitis, peritonitis, or pneumonia associated with probiotics in critically ill patients. In addition, probiotics are associated with risk of the spread of antimicrobial resistance. The therapeutic drug monitoring (TDM)-guided method ensures a true optimization of antibiotic therapy, and particular efforts should be applied globally.
  • 212
  • 15 Mar 2023
Topic Review
TAVIs
The first TAVI was performed by Alain Cribier in an inoperable patient in 2002, and since that moment, transcatheter valve intervention has become an optimal alternative therapy to SAVR for patients with AS. TAVI was introduced in 2004 to treat comorbid patients at high surgical risk, avoiding cardiac arrest and cardiopulmonary bypass while reducing surgical trauma. During the subsequent years, modern transcatheter heart valves (THVs) have become more efficient, and the outcomes of TAVI have constantly improved.
  • 442
  • 06 Sep 2021
Topic Review
Targeted Temperature Management
International guidelines recommend targeted temperature management (TTM) to improve the neurological outcomes in adult patients with post-cardiac arrest syndrome (PCAS). Several studies have indicated that the beneficial effect of hypothermic TTM differs according to the severity of PCAS, suggesting that there may be a subgroup of PCAS patients that is especially likely to benefit from hypothermic TTM. 
  • 449
  • 13 Dec 2021
Topic Review
Surfactant Abnormalities in Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome (ARDS) is a major cause of hypoxemic respiratory failure in adults, leading to the requirement for mechanical ventilation and poorer outcomes. Dysregulated surfactant metabolism and function are characteristic of ARDS. A combination of alveolar epithelial damage leading to altered surfactant synthesis, secretion, and breakdown with increased functional inhibition from overt alveolar inflammation contributes to the clinical features of poor alveolar compliance and alveolar collapse.
  • 166
  • 27 Oct 2023
Topic Review
Severe TBI: Second and Third Tier Therapies
Intracranial hypertension is a common finding in severe traumatic brain injury, and requires treatment in the intensive care unit with intracranial pressure monitoring and, when possible, the application of multimodal neuromonitoring. A three-tier approach is suggested in current rec-ommendations, with higher tier therapies having more significant side effects. Researchers explain the rationale for this approach, they analyze the benefits and risks of each therapeutic mo-dality, and they discuss how to adapt the therapy to the resources available, based on the most recent recommendations.
  • 1.0K
  • 08 Oct 2022
Topic Review
Serotonin
Serotonin (5-hydroxytryptamine, 5-HT) plays two important roles in humans—one central and the other peripheral—depending on the location of the 5-HT pools of on either side of the blood-brain barrier. In the central nervous system it acts as a neurotransmitter, controlling such brain functions as autonomic neural activity, stress response, body temperature, sleep, mood and appetite. This role is very important in intensive care, as in critically ill patients multiple serotoninergic agents like opioids, antiemetics and antidepressants are frequently used. High serotonin levels lead to altered mental status, deliria, rigidity and myoclonus, together recognized as serotonin syndrome. In its role as a peripheral hormone, serotonin is unique in controlling the functions of several organs. In the gastrointestinal tract it is important for regulating motor and secretory functions. Apart from intestinal motility, energy metabolism is regulated by both central and peripheral serotonin signaling. It also has fundamental effects on hemostasis, vascular tone, heart rate, respiratory drive, cell growth and immunity. Serotonin regulates almost all immune cells in response to inflammation, following the activation of platelets. 
  • 3.7K
  • 18 May 2021
Topic Review
Septic Acute Kidney Injury
Sepsis is a life-threatening condition that results from a profoundly dysregulated response to infection. It can lead to organ failure distant from the primary site of the infection, particularly in the kidneys. Sepsis can cause acute kidney injury (AKI). Sepsis and AKI form a vicious cycle, as sepsis is one of the main drivers of critical illness.
  • 162
  • 08 Nov 2023
Topic Review
Prone Positioning in COVID and Non-COVID ARDS
Prone positioning (PP) represents a therapeutic intervention with the proven capacity of ameliorating gas exchanges and ventilatory mechanics indicated in acute respiratory distress syndrome (ARDS). When PP is selectively applied to moderate-severe cases of ARDS, it sensitively affects clinical outcomes, including mortality.
  • 71
  • 18 Feb 2024
Topic Review
Prone Positioning and COVID-19-Related Acute Respiratory Distress
The prone position is a non-invasive technique resulting from the mobilization of the patient, where the person is lying horizontally face down. This technique has been used since the 1970s, but it has gained great relevance in the last year owing to the COVID-19 pandemic with the use of invasive mechanical ventilation.
  • 606
  • 15 Nov 2021
Topic Review
Prolonged Mechanical Ventilation: Outcomes and Management
Prolonged mechanical ventilation (PMV) is defined as successful extubation after more than three spontaneous breathing trials or taking more than 14 days. The pathophysiology of PMV includes the presence of an abnormal respiratory drive or ventilator-induced diaphragm dysfunction. Numerous studies have demonstrated that ventilator-induced diaphragm dysfunction is related to increases in in-hospital deaths, nosocomial pneumonia, oxidative stress, lung tissue hypoxia, ventilator dependence, and costs.
  • 274
  • 24 Jun 2022
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