Intensive care medicine
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Delirium in the critically ill is reported in 11-80% of patients. We estimated the incidence of delirium using a validated scale in a large cohort of ICU patients and determined the associated risk factors and outcomes. ⋯ Delirium is associated with a history of hypertension and alcoholism, higher APACHE II score, and with clinical effects of sedative and analgesic drugs.
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Intensive care medicine · Jan 2007
Impact of antifungal treatment on Candida-Pseudomonas interaction: a preliminary retrospective case-control study.
A pathogenic interaction between Candida albicans and Pseudomonas aeruginosa has recently been demonstrated. In addition, experimental and clinical studies identified Candida spp. tracheobronchial colonization as a risk factor for P. aeruginosa pneumonia. The aim of this study was to determine the impact of antifungal treatment on ventilator-associated pneumonia (VAP) or tracheobronchial colonization due to P. aeruginosa. ⋯ In patients with Candida spp. tracheobronchial colonization, antifungal treatment may be associated with reduced risk for P. aeruginosa VAP or tracheobronchial colonization.
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Intensive care medicine · Jan 2007
Goal-directed fluid management reduces vasopressor and catecholamine use in cardiac surgery patients.
We examined whether guiding therapy by an algorithm based on optimizing the global end-diastolic volume index (GEDVI) reduces the need for vasopressor and inotropic support and helps to shorten ICU stay in cardiac surgery patients. ⋯ Guiding therapy by an algorithm based on GEDVI leads to a shortened and reduced need for vasopressors, catecholamines, mechanical ventilation, and ICU therapy in patients undergoing cardiac surgery.
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Intensive care medicine · Jan 2007
Randomized Controlled Trial Comparative StudyNon-invasive ventilation in chronic obstructive pulmonary disease patients: helmet versus facial mask.
The helmet is a new interface with the potential of increasing the success rate of non-invasive ventilation by improving tolerance. ⋯ Helmet and facial mask were equally tolerated and both were effective in ameliorating gas exchange and decreasing inspiratory effort. The helmet, however, was less efficient in decreasing inspiratory effort and worsened the patient-ventilator interaction.