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Related Experiment Video

Updated: Oct 10, 2025

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
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The critical care literature 2020.

Michael E Winters1, Kami Hu1, Joseph P Martinez1

  • 1Departments of Emergency Medicine and Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

The American Journal of Emergency Medicine
|December 9, 2021
PubMed
Summary

Emergency physicians should update their knowledge on critical care medicine. Key 2020 findings include dexamethasone for COVID-19, adjusted positive end-expiratory pressure, and personalized vasopressor titration for critically ill patients.

Keywords:
COVID-19Cardiac arrestMechanical ventilationPost-cardiac arrestSeptic shockVasopressors

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Area of Science:

  • Emergency Medicine
  • Critical Care Medicine
  • Resuscitation Medicine

Background:

  • Increasing numbers of critically ill patients in emergency departments (EDs) necessitate updated medical knowledge.
  • Persistent patient boarding in EDs highlights the need for efficient critical care management.
  • Emergency physicians require current information on resuscitation and critical care advancements.

Purpose of the Study:

  • To review significant critical care and resuscitation articles from 2020.
  • To inform emergency physicians about key findings relevant to critically ill ED patients.
  • To provide evidence-based recommendations for managing critical conditions.

Main Methods:

  • Annual review of key critical care, emergency medicine, and general medicine journals.
  • Selection of articles based on author opinion regarding importance for ED critical care.
  • Synthesis of findings from selected 2020 publications.

Main Results:

  • Dexamethasone is recommended for mechanically ventilated or oxygen-dependent COVID-19 patients.
  • Lower positive end-expiratory pressure (PEEP) levels are advised for patients without acute respiratory distress syndrome (ARDS).
  • Early extracorporeal membrane oxygenation (ECMO) may benefit out-of-hospital cardiac arrest patients with refractory ventricular fibrillation, if resources permit.

Conclusions:

  • Tranexamic acid should not be administered for acute gastrointestinal bleeding.
  • The combination of vitamin C, thiamine, and hydrocortisone is not recommended for septic shock.
  • Titrate vasopressors to individual chronic perfusion pressure rather than a universal mean arterial pressure target of 65 mmHg for all critically ill patients.