Intensive care medicine
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Intensive care medicine · Jan 2001
Plasma glutamine depletion and patient outcome in acute ICU admissions.
To evaluate whether low plasma glutamine (PG) is related to severity of illness, and actual and predicted hospital mortality. ⋯ Low PG at acute ICU admission is related to higher age, shock as primary diagnosis, and higher hospital mortality. Low PG represents a risk of poor outcome, not fully reflected in the presently used mortality prediction systems.
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Intensive care medicine · Jan 2001
Practice Guideline GuidelineGuidelines for the management of severe sepsis and septic shock. The International Sepsis Forum.
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Intensive care medicine · Jan 2001
Review Practice Guideline GuidelineSource control in the management of sepsis.
The process of surgical decision making is based on both general principles that are amenable to evaluation using rigorous techniques of clinical research and the intangible element of surgical judgment that seeks to apply those principles to the care of an individual patient. The role of surgical judgment is inescapable, even though it is intrinsically subjective and recalcitrant to objective evaluation, for a host of factors modify the application of principle in each patient, and render the circumstances of a given problem sufficiently distinctive, that evidence must be tempered with common sense. We have tried to provide, through an evidence-based approach to a series of questions, the rationale for the basic principles that should guide the clinician in initiating or modifying source control, recognizing that sound clinical judgement demands, at times, that these be set aside. ⋯ Their implementation in practice, however, is more complex, and does not, as a rule, lend itself to simple algorithms that are applicable in all cases. Moreover evidence-based support for these principles is weak. In the final analysis, the elusive process of experienced surgical judgement is invaluable for all but the most straightforward problems.
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Intensive care medicine · Jan 2001
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative clinical trial of progressive dilatational and forceps dilatational tracheostomy.
To compare the safety and early complications of progressive dilatational tracheostomy (PDT) and forceps dilatational tracheostomy (FDT). ⋯ Both percutaneous tracheostomy techniques are safe. The early complication rate of PDT appeared to be lower than FDT, but the early complication rate of FDT may be decreased significantly with small modifications to the set.