We conclude that the specificity and accuracy of the ULBT is significantly higher than the other tests and is more accurate in airway assessment. However, the ULBT in conjunction with the other tests could more reliably predict easy laryngoscopy or intubation.
Objective:Effects of ascorbic acid on hemodynamic parameters of septic shock were evaluated in nonsurgical critically ill patients in limited previous studies. In this study, the effect of high-dose ascorbic acid on vasopressor drug requirement was evaluated in surgical critically ill patients with septic shock.Methods:Patients with septic shock who required a vasopressor drug to maintain mean arterial pressure >65 mmHg were assigned to receive either 25 mg/kg intravenous ascorbic acid every 6 h or matching placebo for 72 h. Vasopressor dose and duration were considered as the primary outcomes. Duration of Intensive Care Unit (ICU) stay and 28-day mortality has been defined as secondary outcomes.Findings:During the study period, 28 patients (14 in each group) completed the trial. Mean dose of norepinephrine during the study period (7.44 ± 3.65 vs. 13.79 ± 6.48 mcg/min, P = 0.004) and duration of norepinephrine administration (49.64 ± 25.67 vs. 71.57 ± 1.60 h, P = 0.007) were significantly lower in the ascorbic acid than the placebo group. No statistically significant difference was detected between the groups regarding the length of ICU stay. However, 28-day mortality was significantly lower in the ascorbic acid than the placebo group (14.28% vs. 64.28%, respectively; P = 0.009).Conclusion:High-dose ascorbic acid may be considered as an effective and safe adjuvant therapy in surgical critically ill patients with septic shock. The most effective dose of ascorbic acid and the best time for its administration should be determined in future studies.
Hemoperfusion (HP) was helpful to prevent the development and progression of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), liver failure, and septic shock by removing cytokines and other inflammatory mediators and ultimately preventing progression toward multiple organ failure. A 54-year-old man diagnosed with COVID-19 was hospitalized in the intensive care unit. The patient's O2 saturation was 80% using an oxygen mask, which was gradually declining. After 4 sessions of HP/continuous renal replacement therapies (CRRT), O2 saturation reached to 95%, and the patient was transferred to the general ward. Performing HP/CRRT at the early stages of ARDS can obviate the need for intubating patients with COVID-19. Punctual and early use of HP and CRRT in the treatment of ARDS in patients with COVID-19 prevented the progression of ARDS and patient intubation, reduced respiratory distress and the patient's dependence on oxygen, prevented other complications such as AKI and septic shock in the patient, and reduced mortality and hospital length of stay.
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