Anidulafungin is an echinocandin armamentarium antifungal drug, indicated for use in invasive can... more Anidulafungin is an echinocandin armamentarium antifungal drug, indicated for use in invasive candidiasis [1]. The mechanism of action is by preventing the synthesis of fungal cell walls [2], However identification and initiation of treatment for invasive candidiasis is difficult and challenging for intensivists in a cohort of critically ill patients during post-operative period. To our knowledge this is the first documented case of such side effects associated with the use of Anidulafungin.
Citation: Alexandra E Lee and Vikram Anumakonda. “A Review of Tracheostomy Practices in an Intens... more Citation: Alexandra E Lee and Vikram Anumakonda. “A Review of Tracheostomy Practices in an Intensive Care Unit amongst Patients Requiring Invasive Ventilation who have Failed Endotracheal Extubation”. EC Pulmonology and Respiratory Medicine 9.11 (2020): 11-21. *Corresponding Author: Vikram Anumakonda, FFICM, FRCP, Consultant Physician, Critical Care Medicine, Dudley Group of Hospital NHS Foundation, UK. Received: February 12, 2020; Published: October 07, 2020
Lack of quality sleep is a major concern in severely ill patients admitted to intensive care unit... more Lack of quality sleep is a major concern in severely ill patients admitted to intensive care units (ICU) across the world. They are regularly under influence of sedatives to tolerate invasive ventilation. These patients experience altered sleep circadian rhythm, minimal sleep in restorative phase, marked by frequent disruptions caused by nursing and medical interventions and ambient noise during the night. Interestingly, approximately 50% have switched their sleep pattern to day time. Melatonin’s primary physiological function is to convey to human body daily circadian variation in of day light and darkness of night. In view of high safety profile and benefits, melatonin has a crucial part in improving sleep in these critically ill patients. Whilst further multi-center clinical trials to address efficacy and efficiency of melatonin are needed, we explore role of an ‘INTEgRATED’ intervention sleep care bundle in an ICU setting.
ImportancePatients with septic shock undergo adrenergic stress, which affects cardiac, immune, in... more ImportancePatients with septic shock undergo adrenergic stress, which affects cardiac, immune, inflammatory, and metabolic pathways. β-Blockade may attenuate the adverse effects of catecholamine exposure and has been associated with reduced mortality.ObjectivesTo assess the efficacy and safety of landiolol in patients with tachycardia and established septic shock requiring prolonged (>24 hours) vasopressor support.Design, Setting, and ParticipantsAn open-label, multicenter, randomized trial involving 126 adults (≥18 years) with tachycardia (heart rate ≥95/min) and established septic shock treated for at least 24 hours with continuous norepinephrine (≥0.1 μg/kg/min) in 40 UK National Health Service intensive care units. The trial ran from April 2018 to December 2021, with early termination in December 2021 due to a signal of possible harm.InterventionSixty-three patients were randomized to receive standard care and 63 to receive landiolol infusion.Main Outcomes and MeasuresThe pri...
Anidulafungin is an echinocandin armamentarium antifungal drug, indicated for use in invasive can... more Anidulafungin is an echinocandin armamentarium antifungal drug, indicated for use in invasive candidiasis [1]. The mechanism of action is by preventing the synthesis of fungal cell walls [2], However identification and initiation of treatment for invasive candidiasis is difficult and challenging for intensivists in a cohort of critically ill patients during post-operative period. To our knowledge this is the first documented case of such side effects associated with the use of Anidulafungin.
Citation: Alexandra E Lee and Vikram Anumakonda. “A Review of Tracheostomy Practices in an Intens... more Citation: Alexandra E Lee and Vikram Anumakonda. “A Review of Tracheostomy Practices in an Intensive Care Unit amongst Patients Requiring Invasive Ventilation who have Failed Endotracheal Extubation”. EC Pulmonology and Respiratory Medicine 9.11 (2020): 11-21. *Corresponding Author: Vikram Anumakonda, FFICM, FRCP, Consultant Physician, Critical Care Medicine, Dudley Group of Hospital NHS Foundation, UK. Received: February 12, 2020; Published: October 07, 2020
Lack of quality sleep is a major concern in severely ill patients admitted to intensive care unit... more Lack of quality sleep is a major concern in severely ill patients admitted to intensive care units (ICU) across the world. They are regularly under influence of sedatives to tolerate invasive ventilation. These patients experience altered sleep circadian rhythm, minimal sleep in restorative phase, marked by frequent disruptions caused by nursing and medical interventions and ambient noise during the night. Interestingly, approximately 50% have switched their sleep pattern to day time. Melatonin’s primary physiological function is to convey to human body daily circadian variation in of day light and darkness of night. In view of high safety profile and benefits, melatonin has a crucial part in improving sleep in these critically ill patients. Whilst further multi-center clinical trials to address efficacy and efficiency of melatonin are needed, we explore role of an ‘INTEgRATED’ intervention sleep care bundle in an ICU setting.
ImportancePatients with septic shock undergo adrenergic stress, which affects cardiac, immune, in... more ImportancePatients with septic shock undergo adrenergic stress, which affects cardiac, immune, inflammatory, and metabolic pathways. β-Blockade may attenuate the adverse effects of catecholamine exposure and has been associated with reduced mortality.ObjectivesTo assess the efficacy and safety of landiolol in patients with tachycardia and established septic shock requiring prolonged (>24 hours) vasopressor support.Design, Setting, and ParticipantsAn open-label, multicenter, randomized trial involving 126 adults (≥18 years) with tachycardia (heart rate ≥95/min) and established septic shock treated for at least 24 hours with continuous norepinephrine (≥0.1 μg/kg/min) in 40 UK National Health Service intensive care units. The trial ran from April 2018 to December 2021, with early termination in December 2021 due to a signal of possible harm.InterventionSixty-three patients were randomized to receive standard care and 63 to receive landiolol infusion.Main Outcomes and MeasuresThe pri...
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