Intensive care medicine
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Intensive care medicine · Nov 2002
Conventional coagulation and thromboelastograph parameters and longevity of continuous renal replacement circuits.
To determine the relationship between conventional and thromboelastograph (TEG) coagulation parameters and continuous renal replacement therapy (CRRT) circuit longevity. ⋯ While TEG variables more closely predicted circuit longevity than conventional coagulation variables, the clinical benefit of TEG monitoring of anticoagulation for CRRT would appear to be minimal.
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Intensive care medicine · Nov 2002
Multicenter StudyTop-down costing: problems in determining staff costs in intensive care medicine.
To describe the activities carried out by the staff of Italian ICUs and to quantify the amount of working time devoted to ICU patients. ⋯ Given the wide variation in the number of activities performed and in the proportion of working time spent performing non-ICU related activities, data comparing costs between different ICUs should be interpreted with caution.
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Intensive care medicine · Nov 2002
Clearance of vancomycin during high-volume haemofiltration: impact of pre-dilution.
To measure the sieving coefficient (SC) and clearance of vancomycin during high-volume haemofiltration (HVHF) and to evaluate the impact of different pre-dilution regimens on these variables. ⋯ HVHF achieves high vancomycin clearances, which despite some deterioration in SC increase with the proportion of replacement fluid given post-filter. Clinicians applying HVHF need to be aware of such clearances to avoid inadequate vancomycin dosing and to adjust therapy according to variations in HVHF technique.
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Intensive care medicine · Nov 2002
Position paper of the ESICM Working Group on Nutrition and Metabolism. Metabolic basis of nutrition in intensive care unit patients: ten critical questions.
The metabolic changes associated with critical illness involve several pathways acting at different steps of the utilization of nutritive substrates. The understanding of the role of these pathways and of their complex regulation has led to the development of new strategies for the metabolic and nutritional management of critically ill patients, including the development of new products for nutritional support. The rationale for changing the profile of nutritional support solutions by adding novel substrates is also discussed. This review focuses on the metabolic specificities of critically ill patients and also includes an analysis of the adequacy of tools to monitor the metabolic status and the adequacy of the nutritional support.
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To assess the prognostic value of procalcitonin levels during the clinical course of meningococcal disease in children. ⋯ Procalcitonin levels on admission are related to severity. In the case of a short disease history (duration of petechiae), PCT levels are also related to mortality. Although PCT levels are elevated in all patients, the levels per se do not allow a prediction about survival versus non-survival, this is in contrast to other markers and scores (PRISM).