RECENT ADVANCES in Critical Care:
Applying the Evidence

Up Objectives Schedule Faculty

OBJECTIVES

Discuss recent evidence showing a reduction in both postoperative complications and hospital length of stay with the use of noninvasive measurements of cardiac output and oxygen delivery versus conventional management.

Summarize the recent research findings demonstrating improved renal outcomes when a conservative approach to IV fluids is used in critically ill patients as compared to a liberal approach.

Contrast the traditional view of reduction in renal blood flow and renal ischemia to the newer, evidence based, multifactorial view regarding the etiology of acute kidney injury in the critically ill.

Explain how pathological changes in the liver can activate the renin-angiotensin-aldosterone system, resulting in intrarenal vasoconstriction and decreased glomerular filtration rate in the patient with liver failure.

Discuss the potential use of recently identified renal biomarkers to allow earlier detection and targeted therapy for acute kidney injury in cirrhosis.

Discuss the significant changes in treatment options for esophageal varices, renal dysfunction, and hepatic encephalopathy for the patient with cirrhosis.

Explain why elective intubation and mechanical ventilation is an essential part of caring for the patient with acute variceal hemorrhage.

Discuss the increasing incidence and prevalence of food, drug or other allergen-induced anaphylaxis as a major public health issue.

Explain why the patient with anaphylaxis may develop arrhythmias or acute coronary syndrome.

Describe the importance of recognizing hypotension or decreased oxygen saturation as the first clinical sign of anaphylaxis in a critically ill ventilated patient.

Explain the utilization of recognition of frailty in critically ill patients and implementation of targeted follow-up in optimizing outcomes following critical illness.

Discuss the relationship between frailty in critically ill patients and adverse outcomes, including cardiovascular events, falls, fractures, and mortality.

Discuss the recent evidence indicating that neurally adjusted ventilator assist (NAVA) offers protection against excessive airway pressure and tidal volume values during mechanical ventilation.

Explain the mechanisms by which neurally adjusted ventilatory assist (NAVA) improves patient-ventilator synchrony.

 

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