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#mcs

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»Nein, wir tragen kein #Parfüm!« sagen die Pflegekräfte, die hier morgens für 5 Minuten mit anpacken.
»Dann sind es eure Klamotten, die duften.« sage ich und reiße das Fenster auf, sobald sie gegangen sind, um den Parfümgestank rauszulassen.
Jetzt habe ich schon wieder Kopfweh und verspüre Übelkeit, wie fast jeden Tag, wenn die PK da waren.
Tausche eigenes Wohlbefinden gegen Entlastung bei der #Pflege = ein Teufelskreis.

#pflegendeAngehörige #MCS #Duftstoffe

(Notiz:
blog.purenature.de/chemikalien)

blog.purenature.deParfüm benutzt? Dann müssen Sie draußen bleiben! | Purenature.de BlogZahl der Duftstoffallergiker nimmt zu, Behörden handeln Parfüms und beduftete Kosmetika können sehr aufdringlich sein, besonders im Sommer. Bei der Hitze kippt

Mechanical circulatory support in cardiogenic shock:
🏛️ VA to be consigned to the museum? NO: systematic use of in AMICS not supported, but is useful as optimal therapies fail
🔍 available evidence & need for: real benefit of ECMO difficult to show in RCTs, especially as will likely continue to be used as rescue strategy
🪡 personalize management! Both VA-ECMO & MFP have a role in severe CS: select most appropriate for the specific patient
🔓 rdcu.be/dLt6T

The infection definitions for ... appropriate for ?? Be cautious:
🍄 most common fungi that cause BSIs are Candida species; if no risk of disseminated infections only obtain conventional blood culture
🩸 blood cultures generally positive from circuit/periphery: avoid accessing circuit. Culturing cannula tip impractical: consider device-related all primary BSI
🧫 circuit/cannula colonization well-described, implications unclear
🖇️ bit.ly/3RtWv5B
🧫 Refers to
🔓 bit.ly/3y1UvdS

Beyond one-size-fits-all in cardiogenic shock: microaxial flow pump, VA or tailored use of mechanical circulatory support? Overview of recent evidence
🫀 VA ECMO in AMI should be reserved for extreme CS
🫀 mAFP appears promising for CS due to STEMI & should be preferred MCS
🪜 initial mAFP use in CS with LV failure + in refractory cases or if severe RV failure may be promising
⚠️ high complication rates associated with underscores need for personalized use
🖇️ bit.ly/4ekPmyd

ECMO alone vs ECPELLA as mechanical circulatory support in cardiogenic shock:
🔍 438 patients, 4 University hospitals 🇫🇷 🇯🇵🇹🇷
🔍 ECMO alone 72.8%, ECPELLA 27.2%: similar early/mid-term survival and incidences of complications
ECMO & ECPELLA seems effective strategies in CS patients requiring temporary for cardiogenic shock. Exploratory subanalyses suggest that simultaneous implantation of ECMO & Impella might shorten recovery time, with reduced ICU & hospital LoS.
🖇️ bit.ly/4dDWaH5

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🫀Routine use of microaxial flow pump vs standard care alone in the treatment of patients with STEMI-related cardiogenic shock led to lower risk of death: results of DanGer Shock international, multicenter RCT out!
🔍 355 pts included in the final analysis
🪦 death from any cause 45.8% in group vs 58.5% in standard-care group
⚠️ incidence of composite of adverse events (bleeding, limb ischemia, hemolysis, device failure, worsening aortic regurgitation) higher with MCS
🖇️ bit.ly/43QZuK5