Intensive care medicine
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Intensive care medicine · May 2009
Multicenter StudyHealth-related quality of life as a prognostic factor of survival in critically ill patients.
To evaluate whether health-related quality of life prior to admission into an intensive care unit (ICU) is a prognostic factor of hospital and 1 year mortality. ⋯ Bad quality of life is associated with hospital mortality and survival 12 months after hospital discharge.
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Intensive care medicine · May 2009
Epidemiology of mechanical ventilation: analysis of the SAPS 3 database.
To evaluate current practice of mechanical ventilation in the ICU and the characteristics and outcomes of patients receiving it. ⋯ Ventilation mode and parameter settings for MV varied significantly across ICUs. Our results provide evidence that some ventilatory modes and settings could still be used against current evidence and recommendations. This includes ventilation with tidal volumes >8mL/kg body weight in patients with a low PaO2/FiO2 ratio and ZEEP in invMV patients. Invasive mechanical ventilation with ZEEP was associated with a worse outcome, even after controlling for severity of disease. Since our study did not document indications for MV, the association between MV settings and outcome must be viewed with caution.
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Intensive care medicine · May 2009
Intraoperative validation of a new system for invasive continuous cardiac output measurement.
Although bolus thermodilution technique for cardiac output (CO) measurement has widespread acceptance, new systems are currently available. We evaluated a continuous CO system (TruCCOMS, Aortech International Inc.) that operates on the thermal conservation principle and we compared it with the reference standard transit time flow measurement (TTFM). ⋯ Although TruCCOMS may significantly underestimate CO, measurement trends correlate with TTFM. For this reason, a negative trend in RV output should trigger more specific diagnostic procedures.
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Intensive care medicine · May 2009
Is C-reactive protein a good prognostic marker in septic patients?
Several studies have shown that C-reactive protein (CRP) is a marker of infection. The aim of this study was to evaluate CRP as marker of prognosis outcome in septic patients and to assess the correlation of CRP with severity of sepsis. ⋯ In septic patients, CRP of the day of sepsis diagnosis is not a good marker of prognosis.
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Intensive care medicine · May 2009
Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to initiation of antimicrobial therapy.
To describe the incidence and outcomes associated with early acute kidney injury (AKI) in septic shock and explore the association between duration from hypotension onset to effective antimicrobial therapy and AKI. ⋯ Early AKI is common in septic shock. Delays to appropriate antimicrobial therapy may contribute to significant increases in the incidence of AKI. Survival was considerably lower for septic shock associated with early AKI, with increasing severity of AKI, and with increasing delays to appropriate antimicrobial therapy.