Intensive care medicine
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Intensive care medicine · Jul 2011
A new method for continuous monitoring of chest wall movement to characterize hypoxemic episodes during HFOV.
Monitoring ventilated infants is difficult during high-frequency oscillatory ventilation (HFOV). This study tested the possible causes of hypoxemic episodes using a new method for monitoring chest wall movement during HFOV in newborn infants. ⋯ Monitoring TDi may enable early recognition of deteriorating ventilation during HFOV that eventually leads to hypoxemia. In about half of cases, hypoxemia is not due to slowly deteriorating ventilation.
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Intensive care medicine · Jul 2011
Impact of a computer-generated alert system on the quality of tight glycemic control.
To assess the impact of a computer-generated blood glucose (BG) alert, generated by a Patient Data Management System (PDMS) and superimposed on a paper-based guideline, on tight glycemic control (TGC) in the intensive care unit (ICU). ⋯ A computer-generated alert was able to statistically significantly improve the quality of TGC in ICU patients without increasing the need for blood sampling.
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Intensive care medicine · Jul 2011
Eosinopenia, an early marker of increased mortality in critically ill medical patients.
Inflammatory markers may have a role in predicting severity of illness of intensive care unit (ICU) patients. The aim of this study is to determine whether low eosinophil count can predict 28-day mortality in medical ICU. ⋯ This study suggests the possibility to use eosinophil cell count at admission and during the first 7 days as a prognosis marker of mortality in medical ICU.
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Intensive care medicine · Jul 2011
Severity of ICU-acquired pneumonia according to infectious microorganisms.
To assess the severity of intensive care unit (ICU)-acquired pneumonia (ICUAP) according to the bacteria involved, classified into seven groups: third-generation cephalosporin-resistant non-fermenting Gram-negative bacilli (resistant C3NF); sensitive C3NF; methicillin-resistant Staphylococcus aureus; methicillin-sensitive Staphylococcus aureus; extended-spectrum beta-lactamase-producing Enterobacteriaceae; Enterobacteriaceae not producing extended-spectrum beta-lactamase; Haemophilus influenzae and Streptococcus pneumoniae. ⋯ ICUAP was responsible for a minor proportion of OD/F occurring during the ICU stay. Severity of ICUAP was related to clinical status prior to ICUAP, but not to the type of bacteria. ICU mortality depended on the severity of ICUAP.
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Intensive care medicine · Jul 2011
Role of distinct phospholipases A2 and their modulators in meconium aspiration syndrome in human neonates.
Meconium aspiration syndrome (MAS) is a life-threatening neonatal lung injury, whose pathophysiology has been mainly studied in animal models. In such models, pancreatic secretory phospholipase A2 (sPLA2-IB) and proinflammatory cytokines present in meconium challenge the lungs, catabolising surfactant and harming the alveoli. Locally produced phospholipases might perpetuate the injury and influence clinical pictures and therapeutic approaches. Our aim is to verify whether pulmonary phospholipase A2 (sPLA2-IIA) is involved in the damage and to determine if phospholipases and their modulators are associated with MAS clinical pictures. ⋯ Pulmonary sPLA2 is locally produced and contributes to the total sPLA2 activity during MAS. CCSP is also produced in trying to lower the inflammation. Both sPLA2 activity and sPLA2-IIA are significantly correlated with oxygenation impairment and haemorrhagic lung oedema.