ICU-READY

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Shock

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Introduction to Shock

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Septic Shock

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Hemorrhagic Shock

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Cardiogenic Shock

Respiratory Failure

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Acute Respiratory Failure

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Acute Respiratory Distress Syndrome (ARDS)

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Analgesia, Sedation, & Delirium

Renal Dysfunction

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Acute Renal Failure

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Acid-Base Disturbances

Cardiac Dysfunction

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Arrhythmias

References

  1. Hernández G, Ospina-Tascón GA, Damiani LP, et al. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA. 2019;321(7):654-664. https://pubmed.ncbi.nlm.nih.gov/30772908/
  1. Sepsis-3: Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. https://pubmed.ncbi.nlm.nih.gov/26903338/

  2. Hernández G, Ospina-Tascón GA, Damiani LP, et al. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA. 2019;321(7):654-664. https://pubmed.ncbi.nlm.nih.gov/30772908/

  3. SMART: Semler MW, Self WH, Wanderer JP, et al. Balanced Crystalloids versus Saline in Critically Ill Adults. New England Journal of Medicine. 2018;378(9):829-839. https://pubmed.ncbi.nlm.nih.gov/29485925/

  4. BaSICS: Zampieri FG, Machado FR, Biondi RS, et al. Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial. JAMA. 2021;326(9):818-829. https://pubmed.ncbi.nlm.nih.gov/34375394/

  5. PLUS: Finfer S, Micallef S, Hammond N, et al. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. New England Journal of Medicine. 2022;386(9):815-826. https://pubmed.ncbi.nlm.nih.gov/35041780/

  6. Hammond Naomi E, Zampieri Fernando G, Di Tanna Gian L, et al. Balanced Crystalloids versus Saline in Critically Ill Adults — A Systematic Review with Meta-Analysis. NEJM Evidence. 2022;1(2):EVIDoa2100010. https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100010

  7. Bentzer P, Griesdale DE, Boyd J, MacLean K, Sirounis D, Ayas NT. Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids? JAMA. 2016;316(12):1298-1309. https://pubmed.ncbi.nlm.nih.gov/27673307/

  8. SOAP II: De Backer D, Biston P, Devriendt J, et al. Comparison of Dopamine and Norepinephrine in the Treatment of Shock. New England Journal of Medicine. 2010;362(9):779-789. https://pubmed.ncbi.nlm.nih.gov/20200382/

  9. VASST: Russell JA, Walley KR, Singer J, et al. Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock. New England Journal of Medicine. 2008;358(9):877-887. https://pubmed.ncbi.nlm.nih.gov/18305265/

  10. Vail E, Gershengorn HB, Hua M, Walkey AJ, Rubenfeld G, Wunsch H. Association Between US Norepinephrine Shortage and Mortality Among Patients With Septic Shock. JAMA. 2017;317(14):1433-1442. https://pubmed.ncbi.nlm.nih.gov/28322415/

  11. Annane Trial: Annane D, Sébille V, Charpentier C, et al. Effect of Treatment With Low Doses of Hydrocortisone and Fludrocortisone on Mortality in Patients With Septic Shock. JAMA. 2002;288(7):862-871. https://pubmed.ncbi.nlm.nih.gov/12186604/

  12. CORTICUS: Sprung CL, Annane D, Keh D, et al. Hydrocortisone Therapy for Patients with Septic Shock. New England Journal of Medicine. 2008;358(2):111-124. https://pubmed.ncbi.nlm.nih.gov/18184957/

  13. APROCCHSS: Venkatesh B, Finfer S, Cohen J, et al. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. New England Journal of Medicine. 2018;378(9):797-808. https://pubmed.ncbi.nlm.nih.gov/29347874/

  14. ADRENAL: Annane D, Renault A, Brun-Buisson C, et al. Hydrocortisone plus Fludrocortisone for Adults with Septic Shock. N Engl J Med. 2018;378(9):809-818. https://pubmed.ncbi.nlm.nih.gov/29490185/
  1. Hernández G, Ospina-Tascón GA, Damiani LP, et al. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA. 2019;321(7):654-664. https://pubmed.ncbi.nlm.nih.gov/30772908/

  2. PPIs: Lau JYW, Sung JJY, Lee KKC, et al. Effect of Intravenous Omeprazole on Recurrent Bleeding after Endoscopic Treatment of Bleeding Peptic Ulcers. New England Journal of Medicine. 2000;343(5):310-316. https://pubmed.ncbi.nlm.nih.gov/10922420/

  3. Octreotide: Gøtzsche PC, Hróbjartsson A. Somatostatin analogues for acute bleeding oesophageal varices. Cochrane Database of Systematic Reviews. 2008(3). https://pubmed.ncbi.nlm.nih.gov/18677774/

  4. Ceftriaxone: Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FI, Soares-Weiser K, Uribe M. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding. Cochrane Database Syst Rev. 2010;2010(9):Cd002907. https://pubmed.ncbi.nlm.nih.gov/20824832/

  5. PROPPR: Holcomb JB, Tilley BC, Baraniuk S, et al. Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma: The PROPPR Randomized Clinical Trial. JAMA. 2015;313(5):471-482. https://pubmed.ncbi.nlm.nih.gov/25647203/

  6. Early TIPS: García-Pagán JC, Caca K, Bureau C, et al. Early Use of TIPS in Patients with Cirrhosis and Variceal Bleeding. New England Journal of Medicine. 2010;362(25):2370-2379. https://pubmed.ncbi.nlm.nih.gov/20573925/
  1. Forrester classification: Forrester JS, Diamond GA, Swan HJ. Correlative classification of clinical and hemodynamic function after acute myocardial infarction. Am J Cardiol. 1977;39(2):137-145. https://pubmed.ncbi.nlm.nih.gov/835473/

  2. Hernández G, Ospina-Tascón GA, Damiani LP, et al. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA. 2019;321(7):654-664. https://pubmed.ncbi.nlm.nih.gov/30772908/

  3. Dobutamine vs Milrinone: Mathew R, Di Santo P, Jung RG, et al. Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock. New England Journal of Medicine. 2021;385(6):516-525. https://pubmed.ncbi.nlm.nih.gov/34347952/

  4. DOSE: Felker GM, Lee KL, Bull DA, et al. Diuretic Strategies in Patients with Acute Decompensated Heart Failure. New England Journal of Medicine. 2011;364(9):797-805. https://pubmed.ncbi.nlm.nih.gov/21366472/

  5. 3CPO: Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J. Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema. New England Journal of Medicine. 2008;359(2):142-151. https://pubmed.ncbi.nlm.nih.gov/18614781/

  6. Berbenetz N, Wang Y, Brown J, et al. Non‐invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane Database of Systematic Reviews. 2019(4). https://pubmed.ncbi.nlm.nih.gov/30950507/
  1. FLORALI: Frat J-P, Thille AW, Mercat A, et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. New England Journal of Medicine. 2015;372(23):2185-2196. https://pubmed.ncbi.nlm.nih.gov/25981908/

  2. HIGH: Azoulay E, Lemiale V, Mokart D, et al. Effect of High-Flow Nasal Oxygen vs Standard Oxygen on 28-Day Mortality in Immunocompromised Patients With Acute Respiratory Failure: The HIGH Randomized Clinical Trial. JAMA. 2018;320(20):2099-2107. https://pubmed.ncbi.nlm.nih.gov/30357270/

  3. Rochwerg B, Granton D, Wang DX, et al. High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: a systematic review and meta-analysis. Intensive Care Medicine. 2019;45(5):563-572. https://pubmed.ncbi.nlm.nih.gov/30888444/

  4. Ferreyro BL, Angriman F, Munshi L, et al. Association of Noninvasive Oxygenation Strategies With All-Cause Mortality in Adults With Acute Hypoxemic Respiratory Failure: A Systematic Review and Meta-analysis. JAMA. 2020;324(1):57-67. https://pubmed.ncbi.nlm.nih.gov/32496521/

  5. Lewis SR, Baker PE, Parker R, Smith AF. High-flow nasal cannulae for respiratory support in adult intensive care patients. Cochrane Database Syst Rev. 2021;3(3):Cd010172. https://pubmed.ncbi.nlm.nih.gov/33661521/

  6. Brochard L, Mancebo J, Wysocki M, et al. Noninvasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. New England Journal of Medicine. 1995;333(13):817-822. https://pubmed.ncbi.nlm.nih.gov/7651472/

  7. Ram FS, Picot J, Lightowler J, Wedzicha JA. Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2004(3):Cd004104. https://pubmed.ncbi.nlm.nih.gov/14974057/

  8. Althoff MD, Holguin F, Yang F, et al. Noninvasive Ventilation Use in Critically Ill Patients with Acute Asthma Exacerbations. American Journal of Respiratory and Critical Care Medicine. 2020;202(11):1520-1530. https://pubmed.ncbi.nlm.nih.gov/32663410/

  9. 3CPO: Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J. Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema. New England Journal of Medicine. 2008;359(2):142-151. https://pubmed.ncbi.nlm.nih.gov/18614781/

  10. Berbenetz N, Wang Y, Brown J, et al. Non-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane Database Syst Rev. 2019;4(4):Cd005351. https://pubmed.ncbi.nlm.nih.gov/30950507/

  11. HACOR: Duan J, Han X, Bai L, Zhou L, Huang S. Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients. Intensive Care Medicine. 2017;43(2):192-199. https://pubmed.ncbi.nlm.nih.gov/27812731/
  1. The ARDS Definition Task Force. Acute Respiratory Distress Syndrome: The Berlin Definition. JAMA. 2012;307(23):2526-2533. https://pubmed.ncbi.nlm.nih.gov/22797452/

  2. Riviello ED, Kiviri W, Twagirumugabe T, et al. Hospital Incidence and Outcomes of the Acute Respiratory Distress Syndrome Using the Kigali Modification of the Berlin Definition. American Journal of Respiratory and Critical Care Medicine. 2016;193(1):52-59. https://pubmed.ncbi.nlm.nih.gov/26352116/

  3. Matthay MA, Thompson BT, Ware LB. The Berlin definition of acute respiratory distress syndrome: should patients receiving high-flow nasal oxygen be included? Lancet Respir Med. 2021;9(8):933-936. https://pubmed.ncbi.nlm.nih.gov/33915103

  4. Shaver CM, Bastarache JA. Clinical and biological heterogeneity in acute respiratory distress syndrome: direct versus indirect lung injury. Clin Chest Med. 2014;35(4):639-653. https://pubmed.ncbi.nlm.nih.gov/25453415/

  5. ARMA: Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress Syndrome. New England Journal of Medicine. 2000;342(18):1301-1308. https://pubmed.ncbi.nlm.nih.gov/10793162/

  6. PROSEVA: Guérin C, Reignier J, Richard J-C, et al. Prone Positioning in Severe Acute Respiratory Distress Syndrome. New England Journal of Medicine. 2013;368(23):2159-2168. https://pubmed.ncbi.nlm.nih.gov/23688302

  7. ROSE: Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome. New England Journal of Medicine. 2019;380(21):1997-2008. https://pubmed.ncbi.nlm.nih.gov/31112383/

  8. FACTT: Comparison of Two Fluid-Management Strategies in Acute Lung Injury. New England Journal of Medicine. 2006;354(24):2564-2575. https://pubmed.ncbi.nlm.nih.gov/16714767/
  1. RASS: Sessler CN, Gosnell MS, Grap MJ, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166(10):1338-1344. https://pubmed.ncbi.nlm.nih.gov/12421743/

  2. Devlin JW, Skrobik Y, Gélinas C, et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Critical Care Medicine. 2018;46(9):e825-e873. https://pubmed.ncbi.nlm.nih.gov/30113379/

  3. Propofol vs Benzos: Lonardo NW, Mone MC, Nirula R, et al. Propofol is associated with favorable outcomes compared with benzodiazepines in ventilated intensive care unit patients. Am J Respir Crit Care Med. 2014;189(11):1383-1394. https://pubmed.ncbi.nlm.nih.gov/24720509/

  4. Propofol vs Precedex: Hughes CG, Mailloux PT, Devlin JW, et al. Dexmedetomidine or Propofol for Sedation in Mechanically Ventilated Adults with Sepsis. New England Journal of Medicine. 2021;384(15):1424-1436. https://pubmed.ncbi.nlm.nih.gov/33528922/

  5. SATs and SBTs: Girard T, Hargett K, and Singh J. Spontaneous Awakening and Breathing Trials. In: Society of Critical Care Medicine, ICU Liberation. 2nd ed. 2020: 19-30. https://www.sccm.org/getattachment/86464100-4b13-4da5-b3d1-39a9a4cceb64/Spontaneous-Awakening-and-Breathing-Trials

  6. Fan E, Zakhary B, Amaral A, et al. Liberation from Mechanical Ventilation in Critically Ill Adults. An Official ATS/ACCP Clinical Practice Guideline. Annals of the American Thoracic Society. 2017;14(3):441-443. https://pubmed.ncbi.nlm.nih.gov/28029806/

  7. Meade M, Guyatt G, Cook D, et al. Predicting Success in Weaning From Mechanical Ventilation. Chest. 2001;120(6, Supplement):400S-424S. https://pubmed.ncbi.nlm.nih.gov/11742961/

  8. Thille AW, Muller G, Gacouin A, et al. Effect of Postextubation High-Flow Nasal Oxygen With Noninvasive Ventilation vs High-Flow Nasal Oxygen Alone on Reintubation Among Patients at High Risk of Extubation Failure: A Randomized Clinical Trial. JAMA. 2019;322(15):1465-1475. https://pubmed.ncbi.nlm.nih.gov/31577036/

  9. De Jong A, Bignon A, Stephan F, et al. Effect of non-invasive ventilation after extubation in critically ill patients with obesity in France: a multicentre, unblinded, pragmatic randomised clinical trial. The Lancet Respiratory Medicine. 2023;11(6):530-539. https://pubmed.ncbi.nlm.nih.gov/36693403/

  10. Acharya R, Kafle S, Shrestha DB, et al. Use of Computed Tomography of the Head in Patients With Acute Atraumatic Altered Mental Status: A Systematic Review and Meta-analysis. JAMA Network Open. 2022;5(11):e2242805-e2242805. https://pubmed.ncbi.nlm.nih.gov/36399344/

  11. CAM-ICU: Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). Jama. 2001;286(21):2703-2710. https://pubmed.ncbi.nlm.nih.gov/11730446/

  12. HOT-ICU: Girard TD, Exline MC, Carson SS, et al. Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness. New England Journal of Medicine. 2018;379(26):2506-2516. https://pubmed.ncbi.nlm.nih.gov/30346242/

  13. AID-ICU: Andersen-Ranberg NC, Poulsen LM, Perner A, et al. Haloperidol for the Treatment of Delirium in ICU Patients. New England Journal of Medicine. 2022;387(26):2425-2435. https://pubmed.ncbi.nlm.nih.gov/36286254/

  14. ICU Liberation Bundle (A-F). Society of Critical Care Medicine https://www.sccm.org/Clinical-Resources/ICULiberation-Home/ABCDEF-Bundles
  1. KDIGO, Section 2: AKI Definition. Kidney International Supplements. 2012;2(1):19-36. https://www.kisupplements.org/article/S2157-1716(15)31031-5/fulltext

  2. Mehta AN, Emmett JB, Emmett M. GOLD MARK: an anion gap mnemonic for the 21st century. The Lancet. 2008;372(9642):892. https://pubmed.ncbi.nlm.nih.gov/18790311/

  3. BICAR-ICU: Jaber S, Paugam C, Futier E, et al. Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. The Lancet. 2018;392(10141):31-40. https://pubmed.ncbi.nlm.nih.gov/29910040/

  4. McMahon GM, Zeng X, Waikar SS. A Risk Prediction Score for Kidney Failure or Mortality in Rhabdomyolysis. JAMA Internal Medicine. 2013;173(19):1821-1827. https://pubmed.ncbi.nlm.nih.gov/24000014/

  5. KDIGO, Section 5: Dialysis Interventions for Treatment of AKI. Kidney International Supplements. 2012;2(1):89-115. https://www.kisupplements.org/article/S2157-1716(15)31034-0/fulltext

  6. AKIKI: Gaudry S, Hajage D, Schortgen F, et al. Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit. New England Journal of Medicine. 2016;375(2):122-133. https://pubmed.ncbi.nlm.nih.gov/27181456/

  7. STARRT-AKI: Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury. New England Journal of Medicine. 2020;383(3):240-251. https://pubmed.ncbi.nlm.nih.gov/32668114/
  1. Mehta AN, Emmett JB, Emmett M. GOLD MARK: an anion gap mnemonic for the 21st century. The Lancet. 2008;372(9642):892. https://pubmed.ncbi.nlm.nih.gov/18790311/
  1. PROPPR: Holcomb JB, Tilley BC, Baraniuk S, et al. Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma: The PROPPR Randomized Clinical Trial. JAMA. 2015;313(5):471-482. https://pubmed.ncbi.nlm.nih.gov/25647203/

  2. Law AC, Bosch NA, Peterson D, Walkey AJ. Comparison of Heart Rate After Phenylephrine vs Norepinephrine Initiation in Patients With Septic Shock and Atrial Fibrillation. Chest. 2022;162(4):796-803. https://pubmed.ncbi.nlm.nih.gov/35526604/

  3. Schmidt AS, Lauridsen KG, Møller DS, et al. Anterior–Lateral Versus Anterior–Posterior Electrode Position for Cardioverting Atrial Fibrillation. Circulation. 2021;144(25):1995-2003. https://pubmed.ncbi.nlm.nih.gov/34814700/

  4. Arrigo M, Jaeger N, Seifert B, Spahn DR, Bettex D, Rudiger A. Disappointing Success of Electrical Cardioversion for New-Onset Atrial Fibrillation in Cardiosurgical ICU Patients. Crit Care Med. 2015;43(11):2354-2359. https://pubmed.ncbi.nlm.nih.gov/26468695/

  5. REVERT: Appelboam A, Reuben A, Mann C, et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015;386(10005):1747-1753. https://pubmed.ncbi.nlm.nih.gov/26314489/

  6. Ceylan E, Ozpolat C, Onur O, Akoglu H, Denizbasi A. Initial and Sustained Response Effects of 3 Vagal Maneuvers in Supraventricular Tachycardia: A Randomized, Clinical Trial. J Emerg Med. 2019;57(3):299-305. https://pubmed.ncbi.nlm.nih.gov/31443919/

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