Intensive care medicine
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Intensive care medicine · Apr 2009
Austrian validation and customization of the SAPS 3 Admission Score.
To test the prognostic performance of the SAPS 3 Admission Score in a regional cohort and to empirically test the need and feasibility of regional customization. ⋯ The SAPS 3 Admission Score's general equation can be seen as a framework for addressing the problem of outcome prediction in the general population of adult ICU patients. For benchmarking purposes, region-specific or country-specific equations seem to be necessary in order to compare ICUs on a similar level.
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Intensive care medicine · Apr 2009
Microvascular flow and tissue oxygenation after major abdominal surgery: association with post-operative complications.
To evaluate the relationship between global oxygen delivery (DO(2)I), microvascular flow and tissue oxygenation in patients who did and did not develop complications following major abdominal surgery. ⋯ In a group of patients with low DO(2)I following major abdominal surgery, microvascular flow abnormalities were more frequent in patients who developed complications. However, there were no differences in DO(2)I, cutaneous PtO(2) or red cell flux between the two groups. Impaired microvascular flow may be associated with the development of post-operative complications.
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Intensive care medicine · Apr 2009
Increased circulating regulatory T cells (CD4(+)CD25 (+)CD127 (-)) contribute to lymphocyte anergy in septic shock patients.
Sepsis syndrome represents the leading cause of death in intensive care unit. Patients present features consistent with a decline in immune responsiveness potentially contributing to mortality. We investigated whether CD4(+)CD25(+) regulatory T cells (Treg) participate in the induction of lymphocyte anergy after sepsis. ⋯ The relative increase in circulating Treg might play a role in lymphocyte anergy described after septic shock and represent a standardizable surrogate marker of declining proliferative capacity after sepsis.
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Intensive care medicine · Apr 2009
Is helmet CPAP first line pre-hospital treatment of presumed severe acute pulmonary edema?
Non-invasive continuous positive airway pressure (CPAP) is effective in reducing intubation rate and mortality of patient with acute cardiogenic pulmonary edema (ACPE). We report our experience on pre-hospital application of CPAP by helmet as an adjunct to medical therapy or as a stand alone procedure in patient with presumed ACPE. ⋯ Helmet CPAP is feasible, efficient and safe in pre-hospital treatment of presumed ACPE. A significant improvement of physiological variables was observed also in the group treated with CPAP in the absence of a drug therapy. We propose helmet CPAP as first line pre-hospital treatment of presumed severe ACPE.
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Intensive care medicine · Apr 2009
LetterFluid resuscitation influences cardiovascular performance and mortality in a murine model of sepsis.
Current murine models of sepsis do not account for the effects of aggressive fluid resuscitation on hemodynamics and mortality. ⋯ In this model, as in human sepsis, the intensity of fluid resuscitation modulates hemodynamic response and mortality. Incorporation of early and aggressive fluid resuscitation can significantly enhances the clinical relevance of murine models of sepsis.