Medications approved for adults often have additional uses in pediatric patients. Such is the case — as described by Wessel and colleagues — for clopidogrel, an agent that blocks the P2Y12 component of adenosine diphosphate (ADP) receptors on the surface of platelets. ADP receptors prevent the activation of the glycoprotein IIb/IIIa receptor complex, thereby reducing […]

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In two meta-analyses and one previous observational study, prone positioning was associated with improved survival for patients with severely hypoxemic acute respiratory distress syndrome (ARDS). However, the findings in these studies were in contradistinction to previously conducted randomized trials. To further evaluate the effectiveness of early prone positioning in severe ARDS, Guerin and colleagues from […]

Metabolomics is a relatively new technology that involves the measurement of an organism’s global metabolic response to some physiologic stress. The study of this technology is gaining momentum, as measurement of a person’s metabolic profile in easily accessible biological fluids can help distinguish disease states from non-disease states earlier. Thus, patients could receive appropriate therapies […]

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Critically ill patients are at risk for significant oxidative stress; however, several small analyses have proposed that supplementation with glutamine, with or without antioxidants, may improve survival. Heyland and colleagues from the Canadian Critical Care Trials Group conducted an international, multicenter study to test the hypothesis that 28-day mortality in critically ill adults would be […]

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Permissive hypercapnia is a well-accepted ventilator strategy for the management of acute respiratory distress syndrome as well as other causes of respiratory failure, such as the respiratory distress syndrome seen in premature infants.  Multiple studies have demonstrated that both myocardial contractility and systemic vascular resistance (SVR) decrease with hypercapnic acidosis, the ultimate effect being that […]

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