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    The critical care literature 2020

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    Author
    Winters, Michael E.
    Hu, Kami
    Martinez, Joseph P.
    Mallemat, Haney
    Brady, William J.
    Date
    2021-09-29
    Journal
    American Journal of Emergency Medicine
    Publisher
    Elsevier Inc.
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.ajem.2021.09.056
    Abstract
    Given the dramatic increase in critically ill patients who present to the emergency department for care, along with the persistence of boarding of critically ill patients, it is imperative for the emergency physician to be knowledgeable about recent developments in resuscitation and critical care medicine. This review summarizes important articles published in 2020 that pertain to the resuscitation and care of select critically ill patients. These articles have been selected based on the authors annual review of key critical care, emergency medicine and medicine journals and their opinion of the importance of study findings as it pertains to the care of critically ill ED patients. Several key findings from the studies discussed in this paper include the administration of dexamethasone to patients with COVID-19 infection who require mechanical ventilation or supplemental oxygen, the use of lower levels of positive end-expiratory pressure for patients without acute respiratory distress syndrome, and early initiation of extracorporeal membrane oxygenation for out-of-hospital cardiac arrest patients with refractory ventricular fibrillation if resources are available. Furthermore, the emergency physician should not administer tranexamic acid to patients with acute gastrointestinal bleeding or administer the combination of vitamin C, thiamine, and hydrocortisone for patients with septic shock. Finally, the emergency physician should titrate vasopressor medications to more closely match a patient's chronic perfusion pressure rather than target a mean arterial blood pressure of 65 mmHg for all critically ill patients.
    Keyword
    Cardiac arrest
    COVID-19
    Mechanical ventilation
    Post-cardiac arrest
    Septic shock
    Vasopressors
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16940
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ajem.2021.09.056
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