8,535 results match your criteria Perioperative Cardiac Management


The impact of a standardized perioperative management on hospital mortality after the Norwood procedure in a low volume center: results and perspectives.

Minerva Pediatr (Torino) 2021 Jun 15. Epub 2021 Jun 15.

Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, ASST Papa Giovanni XXIII, Bergamo, Italy.

Background: Mortality of newborns with Hypoplastic Left Heart Syndrome (HLHS) is mainly concentrated after Norwood procedure (NP) stage 1 palliation (S1P) and between S1P and stage 2 palliation (S2P). Standardized management of these patients may help to control hospital mortality. Aim of the study was to evaluate the impact on hospital mortality of a standardized perioperative management (SPM) for newborns requiring S1P in a low volume center for NP. Read More

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[Preoperative risk assessment of patients with congenital heart disease in non-cardiac surgery].

Ugeskr Laeger 2021 Jun;183(23)

Over the last decades, remarkable advances in survival in patients with congenital heart disease (CHD) have been reported. Currently, 90% of infants born with CHD can expect to reach adulthood. Moderate and severe CHD is associated with increased perioperative mortality. Read More

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Is enhancing recovery after pancreatic cancer surgery even possible?

Chin Clin Oncol 2021 Jun 10. Epub 2021 Jun 10.

College of Medicine and Public Health, Flinders University, South Australia, Australia; Division of Surgery and Perioperative Medicine, Flinders Medical Center, Bedford Park, Adelaide, South Australia, Australia.

Objective: This narrative review traces the evolutionary journey of ERAS® with emphasis on challenges specific to pancreatic cancer. This article will also attempt to explore the barriers to routine ERAS® implementation and offers possible solutions to increasing its uptake and compliance rates.

Background: Enhanced Recovery After Surgery (ERAS®) represents a paradigm shift in the perioperative management of surgical patients using a multi-modality approach each of which is based on best available evidence. Read More

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Successful perioperative management of a primary pulmonary arterial angiosarcoma - Case report.

Braz J Anesthesiol 2021 Jun 9. Epub 2021 Jun 9.

Hospital Universitari Son Espases, Cardiovascular Surgery, Quiron Clinica Rotger and Head of Service, Lead Consultant Cardiac Surgeon, Palma de Mallorca, Spain.

Introduction: Primary pleomorphic pulmonary angiosarcomas are extremely rare tumors which could be easily mistaken for pulmonary emboli.

Background And Findings: We describe the successful perioperative management of a patient with a pulmonary arterial mass which turned out to be a primary pulmonary angiosarcoma. The severe pulmonary hypertension was a particular challenge compounded with the site and adhesions of the tumor, and pulmonary hemorrhage. Read More

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Perioperative liberal versus restrictive fluid strategies and postoperative outcomes: a systematic review and metanalysis on randomised-controlled trials in major abdominal elective surgery.

Crit Care 2021 06 11;25(1):205. Epub 2021 Jun 11.

Department of Anaesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center - IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, MI, Italy.

Background: Postoperative complications impact on early and long-term patients' outcome. Appropriate perioperative fluid management is pivotal in this context; however, the most effective perioperative fluid management is still unclear. The enhanced recovery after surgery pathways recommend a perioperative zero-balance, whereas recent findings suggest a more liberal approach could be beneficial. Read More

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Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes.

Updates Surg 2021 Jun 11. Epub 2021 Jun 11.

Epidemiological Department (SER), Azienda Zero, Via Jacopo Avanzo 35, Veneto Region, 35132, Padua, Italy.

There has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate the impact of aging and comorbidities on outcomes in patients who underwent surgery for the treatment of colorectal cancer (CRC) in Veneto Region (Northeastern Italy). This is a retrospective cohort study in patients ≥ 40 years who underwent elective or urgent CRC surgical resection between January 2013 and December 2015. Read More

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Developments in perioperative management: The yin to the yang of congenital heart surgery.

J Thorac Cardiovasc Surg 2021 May 23. Epub 2021 May 23.

Division of Cardiac Surgery, Children's National Heart Institute, The George Washington University School of Medicine and Health Sciences, Washington, DC. Electronic address:

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European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria.

J Cardiothorac Surg 2021 Jun 10;16(1):171. Epub 2021 Jun 10.

Leipzig Heart center, Leipzig, Germany.

Background: Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Read More

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Regional analgesia in cardiac anesthesia: Welcoming a new era in perioperative pain management.

J Card Surg 2021 Jun 10. Epub 2021 Jun 10.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, University of Miami, Miami, Florida, USA.

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Incidence and Risk Factors of In-Hospital Prosthesis-Related Complications Following Total Knee Arthroplasty: A Retrospective Nationwide Inpatient Sample Database Study.

Orthop Surg 2021 Jun 9. Epub 2021 Jun 9.

Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Objective: To examine the incidence and risk factors of in-hospital prosthesis-related complications (PRCs) following total knee arthroplasty (TKA) using a large-scale national database.

Methods: A retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2005-2014. Patients who underwent TKA were included. Read More

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The Future Directions of Research in Cardiac Anesthesiology.

Adv Anesth 2020 Dec;38:269-282

Department of Anesthesia, Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada; Departments of Anesthesia and Physiology, University of Toronto, Toronto, ON, Canada. Electronic address:

This article provides an overview of knowledge gaps that need to be addressed in cardiac anesthesia, including mitigating the inflammatory effects of cardiopulmonary bypass, defining myocardial infarction after cardiac surgery, improving perioperative neurologic outcomes, and the optimal management of patients undergoing valve replacement. In addition, emerging approaches to research conduct are discussed, including the use of new analytical techniques like machine learning, pragmatic trials, and adaptive designs. Read More

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December 2020

Anesthesia for the Patient with Severe Liver Failure.

Adv Anesth 2020 Dec;38:251-267

Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 3 Eaton North, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. Electronic address:

The incidence of liver failure continues to increase, and it is associated with increased perioperative morbidity and mortality. Liver failure is associated with multiorgan dysfunction, including central nervous, cardiac, respiratory, gastrointestinal, renal, and hematological systems. Preoperative identification, optimization, and tailored anesthetic management are essential for optimum outcomes in patients with liver disease undergoing surgery. Read More

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December 2020

Anesthetic management in lung transplantation: Our single-center experience.

Turk Gogus Kalp Damar Cerrahisi Derg 2021 Apr 26;29(2):191-200. Epub 2021 Apr 26.

Department of Anesthesiology and Reanimation, Kartal Koşuyolu High Specialization Education and Research Hospital, Istanbul, Turkey.

Background: In this study, we aimed to discuss our anesthesia management strategies, experiences, and outcomes in patients undergoing lung transplantation.

Methods: Between December 2016 and December 2018, a total of 53 patients (43 males, 10 females; mean age: 46.1±13 years; range, 14 to 64 years) undergoing lung transplantation in our center were included. Read More

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Is arterial switch operation possible with neonatology-focused intensive care unit modality.

Turk Gogus Kalp Damar Cerrahisi Derg 2021 Apr 26;29(2):136-142. Epub 2021 Apr 26.

Department of Pediatric Cardiology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

Background: In this study, we aimed to examine the feasibility of arterial switch operation and its perioperative management with neonatology-focused intensive care modality in a region of Turkey where the birth rate and the number of asylum seekers who had to leave their country due to regional conflicts are high.

Methods: Between December 2017 and June 2020, a total of 57 patients (48 males, 9 females; median age: 12.2 days; range, 2 to 50 days) who were diagnosed with transposition of the great arteries in our clinic and underwent arterial switch operation were retrospectively analyzed. Read More

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Patient blood management in India - Review of current practices and feasibility of applying appropriate standard of care guidelines. A position paper by an interdisciplinary expert group.

J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):3-13. Epub 2021 Apr 10.

Department of Obstetrics and Gynaecology, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

In a developing country like India, with limited resources and access to healthcare facilities, dealing with massive hemorrhage is a major challenge. This challenge gets compounded by pre-existing anemia, hemostatic disorders, and logistic issues of timely transfer of such patients from peripheral hospitals to centers with adequate resources and management expertise. Despite the awareness amongst healthcare providers regarding management modalities of bleeding patients, no uniform Patient Blood Management (PBM) or perioperative bleeding management protocols have been implemented in India, yet. Read More

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Cystic fibrosis foundation consensus statements for the care of cystic fibrosis lung transplant recipients.

J Heart Lung Transplant 2021 Apr 22. Epub 2021 Apr 22.

Division of Pulmonary and Critical Care, Washington University School of Medicine, St. Louis, Missouri. Electronic address:

Cystic fibrosis (CF) is the indication for transplantation in approximately 15% of recipients worldwide, and Cystic Fibrosis Lung Transplant Recipients (CFLTRs) have excellent long-term outcomes. Yet, CFLTRs have unique comorbidities that require specialized care. The objective of this document is to provide recommendations to CF and lung transplant clinicians for the management of perioperative and underlying comorbidities of CFLTRs and the impact of transplantation on these comorbidities. Read More

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Re-exploration for bleeding after cardiac surgery: revaluation of urgency and factors promoting low rate.

J Cardiothorac Surg 2021 Jun 7;16(1):166. Epub 2021 Jun 7.

Cardiothoracic Surgery Department, Zagazig University, Zagazig, Egypt.

Background: Re-exploration of bleeding after cardiac surgery is associated with significant morbidity and mortality. Perioperative blood loss and rate of re-exploration are variable among centers and surgeons.

Objective: To present our experience of low rate of re-exploration based on adopting checklist for hemostasis and algorithm for management. Read More

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Pre and postoperative predictors of clinical outcome of fenestrated and branched endovascular repair for complex abdominal and thoracoabdominal aortic aneurysms in an Italian multicenter registry.

J Vasc Surg 2021 Jun 4. Epub 2021 Jun 4.

Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy.

Objective: Complex aortic aneurysms (juxtarenal j-AAA, pararenal p-AAAs, thoracoabdominal TAAAs) are treated with increasing frequency through fenestrated and branched endovascular repair (F/B-EVAR), however the outcome of these procedures is usually reported separately by single experiences and wider overviews are not frequent. The aim of this study was therefore to report an Italian experience analyzing the results obtained in 4 academic centers in order to evaluate predictors of outcome.

Methods: Between 2008 and 2019, all consecutive patients undergoing F/B-EVAR in 4 Italian university centers were prospectively recorded and retrospectively analyzed. Read More

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COVID-19 complicating perioperative management of LVAD implantation: A case report and systematic review.

J Card Surg 2021 Jun 6. Epub 2021 Jun 6.

Department of Heart Failure, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

The coronavirus 2019 disease (COVID-19) affected 125 million people worldwide and caused 2.7 million deaths. Some comorbidities are associated with worse prognosis and left ventricular assist device (LVAD) recipients are probably part of this high-risk population. Read More

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Transitions of Care After Critical Illness-Challenges to Recovery and Adaptive Problem Solving.

Crit Care Med 2021 Jun 5. Epub 2021 Jun 5.

Department of Physiotherapy, Western Health, Sunshine Hospital, Melbourne, VIC, Australia. Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, VIC, Australia. School of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia. Department of Physiotherapy, Western Health, Melbourne, VIC, Australia. School of Nursing, Vanderbilt University, Nashville, TN. Department of Internal Medicine, Section of Pulmonary, Critical Care, Allergy and Immunology, Wake Forest University School of Medicine, Winston Salem, NC. Department of Perioperative Medicine, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom. Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA. School of Nursing, University of Pittsburgh, Pittsburgh, PA. University College London Hospitals NHS Foundation Trust, London, United Kingdom. Division of Critical Care Medicine, Albert Einstein College of Medicine of Yeshiva University, New York, NY. Vanderbilt University Medical Center, Nashville, TN. Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN. University Hospitals Cleveland Medical Center, Cleveland, OH. Pulmonary and Critical Care Medicine, Geisinger Medical Center, Mechanicsville, PA. Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Scotland, United Kingdom. Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom. Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, KY. School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland, United Kingdom. Emory University Hospital (Emory Healthcare), Atlanta, GA. Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD. Department of Medicine, Division of Pulmonary and Critical Care, Intermountain Medical Center, Murray, UT. Center for Humanizing Critical Care, Intermountain Health Care, Murray, UT. Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT. Department of Medicine, Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI. Division of Pulmonary, Allergy, and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA. Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.

Objectives: Investigate the challenges experienced by survivors of critical illness and their caregivers across the transitions of care from intensive care to community, and the potential problem-solving strategies used to navigate these challenges.

Design: Qualitative design-data generation via interviews and data analysis via the framework analysis method.

Setting: Patients and caregivers from three continents, identified through the Society of Critical Care Medicine's THRIVE international collaborative sites (follow-up clinics and peer support groups). Read More

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Hydroxyethyl starch and acute kidney injury in high-risk patients undergoing cardiac surgery: A prospective multicenter study.

J Clin Anesth 2021 Oct 2;73:110367. Epub 2021 Jun 2.

Department of Anesthesia and Perioperative Medicine, Hospital Universitari de Girona Dr J Trueta, University of Girona, Instut d'Investigació Biomédica de Girona (IDIBGI), Spain. Electronic address:

Background: Hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients admitted to intensive care unit (ICU) for medical indications. We conducted a cohort study to evaluate the renal safety of modern 6% HES solutions in high-risk patients having cardiac surgery.

Method: In this multicentre prospective cohort study, we recruited 261 consecutive patients at high-risk for developing cardiac surgery-associated AKI, based on a Cleveland score ≥ 4 points, from July to December 2017th in 14 hospitals in Spain and the United Kingdom. Read More

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October 2021

Transcarotid Versus Transaxillary/Subclavian Transcatheter Aortic Valve Replacement (TAVR): Analysis of Outcomes.

J Cardiothorac Vasc Anesth 2021 Apr 28. Epub 2021 Apr 28.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN. Electronic address:

Transcatheter aortic valve replacement (TAVR) has revolutionized the percutaneous management of valvular heart disease and has evolved to progressively minimalist techniques over the past decade. This review discusses the impact of minimalist TAVR, explores the alternative approaches when transfemoral (TF) TAVR is not possible, and analyzes the current outcomes of transcarotid (TC) versus transaxillary/subclavian (TAx) TAVR, which are the two leading nonfemoral (NF) approaches emerging as the preferred alternatives to TF TAVR. Read More

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A Patient With Kearns Sayre Syndrome and Charcot-Marie-Tooth for Supraventricular Tachycardia Ablation: A Case Report.

A A Pract 2021 Jun 2;15(6):e01488. Epub 2021 Jun 2.

From the Department of Anesthesiology and Perioperative Medicine, University of Missouri, Columbia, Missouri.

Kearns Sayre syndrome (KSS) is a rare mitochondrial myopathy that is associated with progressive impaired ventilatory drive, heart block, and peripheral neuropathy. Charcot-Marie-Tooth disease (CMT) is a rare chronic motor and sensory peripheral neuropathy which includes muscle weakness and restrictive pulmonary impairment. Patients with either condition having anesthesia can have postoperative respiratory failure. Read More

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Outcome of Organ Dysfunction in the Perioperative Period.

Anesth Analg 2021 Jun 1. Epub 2021 Jun 1.

Department of Anesthesiology, Stony Brook Medicine, Stony Brook, New York.

While intraoperative mortality has diminished greatly over the last several decades, the risk of death within 30 days of surgery remains stubbornly high and is ultimately related to perioperative organ failure. Perioperative strokes, while rare (<2% in noncardiac surgery), are associated with a more than 10-fold increase in mortality. Rapid identification and treatment are key to maximizing long-term outcomes. Read More

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The international ENIGMA-II substudy on postoperative cognitive disorders (ISEP).

Sci Rep 2021 Jun 2;11(1):11631. Epub 2021 Jun 2.

Department of Anesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, VIC, Australia.

There is a large controversy as to whether nitrous oxide (NO) added to the anaesthetic gas mixture is harmful or harmless for postoperative cognitive function recovery. We performed a nested study in the ENIGMA-II trial and compared postoperative neurocognitive recovery of patients randomly receiving NO (70%) or Air (70%) in 30% O during anesthesia. We included adults having non cardiac surgery. Read More

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Understanding perioperative patient blood management practices in Europe: Are we following the guidelines?

J Clin Anesth 2021 Oct 29;73:110349. Epub 2021 May 29.

Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address:

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October 2021

Diagnostic Point-of-Care Ultrasound: Recommendations From an Expert Panel.

J Cardiothorac Vasc Anesth 2021 Apr 17. Epub 2021 Apr 17.

Department of Anesthesiology, University of Utah, Salt Lake City, UT.

Diagnostic point-of-care ultrasound (PoCUS) has emerged as a powerful tool to help anesthesiologists guide patient care in both the perioperative setting and the subspecialty arenas. Although anesthesiologists can turn to guideline statements pertaining to other aspects of ultrasound use, to date there remains little in the way of published guidance regarding diagnostic PoCUS. To this end, in 2018, the American Society of Anesthesiologists chartered an ad hoc committee consisting of 23 American Society of Anesthesiologists members to provide recommendations on this topic. Read More

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Lidocaine for postoperative pain after cardiac surgery: a systematic review.

J Cardiothorac Surg 2021 May 31;16(1):157. Epub 2021 May 31.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA.

Objective: Lidocaine is one of the most widely used local anesthetics with well-known pharmacological properties. The purpose of this systematic review is to investigate the effects of lidocaine on postoperative pain scores and recovery after cardiac surgery.

Methods: A comprehensive database search was conducted by a reference librarian for randomized clinical trials (RCT) from January 1, 1980 to September 1, 2019. Read More

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Impact of Modified Anesthesia Management for Pediatric Patients With Williams Syndrome.

J Cardiothorac Vasc Anesth 2021 Apr 20. Epub 2021 Apr 20.

Division of Pediatric Cardiac Anesthesia, Lucile Packard Children's Hospital Stanford and Stanford University School of Medicine, Palo Alto, CA.

Objective: This study compared the percent change in systolic blood pressure and the incidence of adverse cardiac events (ACEs; defined as cardiac arrest, cardiopulmonary resuscitation, arrhythmias, or ST-segment changes) during anesthesia induction in patients with Williams syndrome (WS) before and after implementation of a perioperative management strategy.

Design: Retrospective observational cohort study.

Setting: Single quaternary academic referral center. Read More

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RAND appropriateness panel to determine the applicability of UK guidelines on the management of acute respiratory distress syndrome (ARDS) and other strategies in the context of the COVID-19 pandemic.

Thorax 2021 May 27. Epub 2021 May 27.

Guy's and St Thomas' NHS Foundation Trust, London, UK.

Background: COVID-19 has become the most common cause of acute respiratory distress syndrome (ARDS) worldwide. Features of the pathophysiology and clinical presentation partially distinguish it from 'classical' ARDS. A Research and Development (RAND) analysis gauged the opinion of an expert panel about the management of ARDS with and without COVID-19 as the precipitating cause, using recent UK guidelines as a template. Read More

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