Ugeskrift for laeger
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Ugeskrift for laeger · Feb 2007
Review[Antibiotic strategies in the treatment of infection in critically ill patients].
Inappropriate antimicrobial therapy of pneumonia, severe sepsis and bacteraemia is associated with high mortality. Adjustment of insufficient initial antibiotics after susceptibility testing does not reduce mortality. ⋯ The initial broad-spectrum should be narrowed according to bacterial susceptibility data. This evidence-based intervention ensures appropriate antimicrobial treatment to critically ill patients to improve outcome and reduction of the use of broad-spectrum antibiotics.
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The practice of paediatric intensive care has matured dramatically over the past 20 years with improving intensive care unit mortality rates and a positive effect on child survival. This paper gives an overview of many of these aspects, and attempts to present a picture of the present situation in Denmark. ⋯ In Denmark, critically ill children are cared for in at least 27 primarily adult intensive care units by nurses and doctors who are not specifically trained in paediatric intensive care. Suggestions for a more centralisation of paediatric intensive care in Denmark are made.
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Ugeskrift for laeger · Feb 2007
[Capacity in Danish intensive care units. A national survey of capacity, cancellations and transfers of critically ill patients].
A shortage of intensive care beds and fully-booked intensive care units has a range of undesirable consequences for patients and personnel, eg. transfer to other intensive care units, cancellation of operations, tighter visitation criteria and an increase in the work-load. The problem is illustrated in a national survey. ⋯ This survey documents that there is a problem with the capacity in Danish intensive care units. Establishing more intensive care beds in selected departments, ensuring personnel for the beds already established and establishing intermediate care beds could relieve the shortage of beds.
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Ugeskrift for laeger · Feb 2007
Comparative Study[Measurement of intraabdominal pressure and abdominal compartment syndrome in surgical and intensive care units].
Over the past number of years, there has been an increasing interest in the pathophysiological phenomena intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Foreign studies have shown considerably national differences in the interpretation of the two phenomena. The purpose of this questionnaire study was to survey which group of patients is examined for IAH and ACS, how the examination is carried out and how the two conditions are treated in surgical and intensive care units in Denmark. ⋯ Considering the differences in clinical practice and the discrepancy to international guidelines interdisciplinary national guideline might contribute to a more uniform evaluation and treatment of patients with IAH or ACS.
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Cardio-thoracic intensive care units primarily receive patients for recovery following cardio-thoracic surgery. Approximately 70% of the patients belong to this category. 18% are patients who are admitted or readmitted directly. Transplantations, pulmonary endarterectomy, congenital heart diseases and therapeutic hypothermia patients are a small group (12%) but make up a large part of the activity because of their extended length of stay. The use of ventricular assist devices and extracorporeal membrane oxygenation are both important in the future management of cardio-ventilatory recovery.