Intensive care medicine
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Intensive care medicine · Aug 2004
Variation of infected cell count in bronchoalveolar lavage and timing of ventilator-associated pneumonia.
The aim of this study was to evaluate and compare the accuracy of the percentage of infected cells (%IC) in bronchoalveolar lavage (BAL) for ventilator-associated pneumonia (VAP) diagnosis according to its onset from the initiation of mechanical ventilation. ⋯ A relationship between the %IC in BAL, duration of ventilation, quantitative culture of BAL and ongoing antimicrobial therapy has been proved in this study. The %IC for VAP diagnosis may not be accurate in patients with ongoing antibiotics and late onset infections (>7 days).
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Intensive care medicine · Aug 2004
Incidents relating to the intra-hospital transfer of critically ill patients. An analysis of the reports submitted to the Australian Incident Monitoring Study in Intensive Care.
Transportation of critically ill patients within the hospital poses important risks. We sought to identify causes, outcomes and contributing factors associated with intra-hospital transport. ⋯ Intra-hospital transport poses an important risk to ICU patients. The adequate provision of highly qualified staff, specially designed and well maintained equipment, as well as continuous monitoring are essential to avoid/mitigate these incidents. Professional societies and local units should adopt guidelines/protocols for intra-hospital transportation. Monitoring of incidents should aid in the continuous improvement in patient safety.
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Intensive care medicine · Aug 2004
Hyperglycaemia and mortality in critically ill patients. A prospective study.
To describe hyperglycaemia as a possible marker of morbidity and mortality in critically ill medical and surgical patients admitted to a multidisciplinary ICU. ⋯ High blood glucose level during the stay in ICU was a marker of increased morbidity and mortality in critically ill surgical patients. In medical patients the same trend was found, but non-significant. The population of patients in the present study are heterogeneous and the results from surgical critically ill patients should not be generalised to medical patients.
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To describe the incidence of the catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) of central venous catheters (CVCs) and arterial catheters (ACs). ⋯ In the CDC guidelines, catheter insertion at the subclavian site is recommended in preference to femoral and jugular accesses, and there is no recommendation about AC site insertion. Our data support these recommendations about CVCs. Because the AC infection rate was very low, our study suggests that the access site is probably not of major importance for this type of catheter.