Icu Director 

About: Icu Director is an academic journal. The journal publishes majorly in the area(s): Intensive care unit & Intensivist. Over the lifetime, 154 publications have been published receiving 323 citations.

An Evidence-Based Approach for Integrating Bedside Ultrasound Into Routine Practice in the Assessment of Undifferentiated Shock:

Abstract: Undifferentiated hypotension remains a central diagnostic and therapeutic challenge in emergency and critical care medicine. Increasingly, bedside ultrasound conducted by intensivists and emergency medicine providers is assuming a central role in diagnosis and resuscitation of hypotension. This review discusses sample algorithms for the bedside ultrasonographic assessment of undifferentiated shock and outlines an evidence-based framework for the intensivist seeking to incorporate bedside ultrasound into daily clinical practice. The literature regarding specific applications including cardiac, thoracic, pulmonary, and vascular assessment is briefly reviewed, as is the evidence pertaining to effective implementation, training, credentialing, and ongoing quality assurance.

Therapeutic Hypothermia After Perioperative Cardiac Arrest in Cardiac Surgical Patients

Abstract: Background. Therapeutic hypothermia (TH) has been established as an effective treatment for preserving neurological function after out-of-hospital cardiac arrest (CA). Use of TH has been limited in cardiac surgery patients in particular because of concern about adverse effects such as hemorrhage and dysrhythmia. Little published data describe efficacy or safety of TH in cardiac surgical patients who suffer unintentional CA. However, the benefits of TH are such as may suggest clinical equipoise, even in this high-risk patient population. Objective. To report a series of 3 patients in our institution’s cardiac surgery ICU who suffered unintentional CA within 48 hours of cardiac surgery and were treated with TH. Methods. After institutional review board approval, study patients were identified by diagnosis of undesired intraoperative CA or arrest on ICU days 1 to 2, as well as having documented TH. The institution’s electronic medical record and the Society of Thoracic Surgeons database were retrospectively ...

Perioperative Coagulopathy, Bleeding, and Hemostasis During Cardiac Surgery A Comprehensive Review

Abstract: Cardiac surgery patients use 10%-25% of the blood products transfused annually in the United States. The transfusion of red blood cells or blood products has been the subject of intense scrutiny over the past 10 years. Bleeding after cardiac surgery can be surgical or nonsurgical and lead to hemodynamic compromise and surgical reexploration. Because hemorrhage and blood product transfusions are associated with multiple negative outcomes, including increased mortality, it is prudent to understand the mechanisms responsible for nonsurgical bleeding. This review focuses on the physiology of the normal coagulation and fibrinolysis, risk factors associated with patients presenting for cardiac surgery, impairments of normal hemostasis associated with cardiac surgery and cardiopulmonary bypass (CPB), and potential interventions to reduce perioperative blood loss and blood transfusion.

Frequency and Outcomes of Hyperlactatemia After Neurosurgery A Retrospective Analysis

Abstract: Objectives. The aim of this study was to evaluate the incidence and significance of elevated serum lactate and its impact on outcome in postoperative neurosurgical patients admitted to neurosurgica...