Blacks, Hispanics, and other racial minorities in the United States were observed to exhibit significantly higher in-hospital sepsis-related respiratory failure associated mortality when compared with non-Hispanic whites.

In the United States, between 2008 and 2012, there was an increasing trend toward the use of ECMO in patients with ARDS that coincided with a slight increase in survival among these patients.

Background Sleep quality and quantity are severely reduced in critically ill patients receiving mechanical ventilation with potential for adverse consequences. Our objective was to synthesize the randomized controlled trials (RCTs) that measured the efficacy of sleep-promoting interventions on sleep quality and quantity in critically ill patients. Methods We included RCTs that objectively measured sleep with electroencephalography or its derivatives and excluded observational studies and those that measured sleep by subjective reports. The research was performed according to PRISMA guidelines. Results Of 6,022 studies identified, 13 studies met eligibility criteria involving 296 critically-ill patients. Eight trials looked at different modes of mechanical ventilation as sleep interventions, and the remaining five involved pharmacological, non-pharmacological, or environmental interventions. Meta-analysis of the studies revealed that sleep-promoting interventions improved sleep quantity (pooled standardized mean of differences [SMD] 0.37, 95%CI: 0.05, 0.69; P=0.02) and sleep quality through reduction in sleep fragmentation (SMD −0.31; 95%CI −0.60, −0.01; P=0.04). Subgroup analysis revealed that timed-modes of ventilation improved sleep quantity when compared to spontaneous-modes of ventilation (SMD 0.45, 95%CI 0.10, 0.81; P=0.01). Non-mechanical ventilation interventions tended to improve sleep quantity (SMD 0.65; 95%CI; −0.03, 1.33; P=0.06) and tended to reduce sleep fragmentation (SMD −0.29; 95% CI −0.61, 0.03; P=0.07). Conclusions The synthesized evidence suggests that both mechanical ventilation and non-mechanical ventilation-based therapies improve sleep quantity and quality in critically ill patients but the clinical significance is unclear. In the future, adequately-powered multi-center RCTs involving pharmacological interventions to promote sleep in critically ill patients are warranted.

Advances in the imaging techniques of the heart have fueled the interest in understanding of right heart pathology. Recently, speckle tracking echocardiography has shown to aid in understanding various right heart diseases and better management. Its role is well established in diagnosing right heart failure, pulmonary artery hypertension, arrhythmogenic right ventricular dysplasia and congenital heart disease. We review the basic mechanics of speckle tracking and analyze its role in various right heart conditions.

NL, et al. E-cigarette use results in suppression of immune and inflammatory-response genes in nasal epithelial cells similar to cigarette smoke.