Intensive care medicine
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Intensive care medicine · Mar 2003
CommentNosocomial bacteremia involving Acinetobacter baumannii in critically ill patients: a matched cohort study.
To determine outcome and attributable mortality in critically ill patients with nosocomial bacteremia involving A. baumannii. ⋯ In critically ill patients A. baumannii bacteremia is not associated with a significantly increased mortality rate.
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Intensive care medicine · Mar 2003
Monitoring of cerebral perfusion pressure during intracranial hypertension: a sufficient parameter of adequate cerebral perfusion and oxygenation?
A cerebral perfusion pressure (CPP) oriented treatment is a widely accepted standard for patients with intracranial hypertension. In an animal model of controlled intracranial hypertension we investigated whether CPP is a reliable parameter of sufficient cerebral perfusion and oxygenation. Using near-infrared reflexion spectroscopy the effect of decreasing CPP due to increasing intracranial pressure (ICP) on cerebral tissue oxygenation was studied. ⋯ Regarding the EEG effects due to increased ICP (EEG silence), CPP values showed a wide interindividual variability, in contrast to tiSO(2). In our animal model the sole calculation of CPP did not reflect adequate cerebral perfusion.
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Intensive care medicine · Mar 2003
Portable computed tomography performed on the intensive care unit.
We report on the use of portable computed tomography (CT) in an ICU setting. The additional diagnostic gain and therapeutic consequences were assessed. ⋯ To perform portable CT in the interventional suite on the ICU allows immediate minimally invasive therapeutic interventions and provides full ICU monitoring.
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Intensive care medicine · Mar 2003
Surviving intensive care: a report from the 2002 Brussels Roundtable.
The traditional goal of intensive care has been to decrease short-term mortality. While worthy, this goal fails to address the issue of what it means to survive intensive care. Key questions include whether intensive care survivors have optimal long-term outcomes and whether ICU care decisions would change if we knew more about these outcomes. ⋯ There are also opportunities today to improve care. Key to taking advantage of such opportunities is the need for a global awareness of critical illness as an entity that begins and ends outside the ICU 'box'. Specific interventions that show promise for improving care include ICU discharge screening tools and ICU follow-up clinics.