Critical Care

Manual Compression of Abdomen can help assess Flow Limitation in patients on Mechanical Ventilation

Expiratory flow limitation (EFL) in a patient on mechanical ventilation can have varied cardiopulmonary consequences. Hence ascertaining the presence or absence of expiratory flow limitation is of paramount importance. Expiratory flow limitation can lead to incomplete emptying of air during expiration. The air is trapped within the lungs causing hyperinflation, dynamic small airway compression and increased intrinsic PEEP (Positive end expiratory pressure). Dynamic small airway compression can...

Restricting Calories does not increase Ventilator Free Days in Acute Lung Injury Patients

The protocol for feeding in acute lung injury patients on ventilator has always been debatable. While some physicians prefer full enteral feeding as they feel increased nutrition increases the chances of healing, other physicians prefer to restrict the number of calories initially as they feel the gastro-intestinal problems associated with higher calorie intake may delay the chance of healing. A new study published in the Journal of American Medical Association has found that reducing the...

Surveillance Tracheal Aspirate Culture doesn't Accurately Predict the Cause of LRTI

  It is a routine practice among pediatric surgeons to get the culture of tracheal aspirate done in children with tracheostomy tubes and suffering from lower respiratory tract infection. It is believed that the bacteria in the culture of tracheal aspirate must be the bacteria responsible for the respiratory tract infection. However, a new study published in the journal Chest has found that the surveillance tracheal aspirate culture is not of much use at it does not correctly predict the...

Inappropriate antibiotic therapy in sepsis increases the duration of hospitalization

Early and appropriate antibiotic therapy is one of the cornerstones of sepsis management. In a study conducted in a large academic center it was found that nearly one third of the patients received inappropriate antibiotic therapy initially. The inappropriate therapy includes situations where the antibiotic was administered later than 24 hours from the onset of sepsis and using antibiotic for which the organism is resistant. The study showed that the delay in starting the antibiotic was...

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