Intensive care medicine
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Intensive care medicine · Sep 2011
Comparative StudyLung ultrasound in critically ill patients: comparison with bedside chest radiography.
To compare the diagnostic performance of lung ultrasound and bedside chest radiography (CXR) for the detection of various pathologic abnormalities in unselected critically ill patients, using thoracic computed tomography (CT) as a gold standard. ⋯ In our unselected general ICU population lung ultrasound has a considerably better diagnostic performance than CXR for the diagnosis of common pathologic conditions and may be used as an alternative to thoracic CT.
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Intensive care medicine · Sep 2011
Predicting prolonged intensive care unit stays in older cardiac surgery patients: a validation study.
In cardiac surgery prediction models identifying patients at risk of prolonged stay at the Intensive Care Unit (ICU) are used to optimize treatment and use of ICU resources. A recent systematic validation study of 14 of these models identified three models with a good predictive performance across patients of all ages. It is however unclear how these models perform in older patients, who nowadays form a considerable part of this patient population. The current study specifically validates the performance of these three models in older cardiac surgery patients and quantifies how their performance changes with increasing age of patients. ⋯ To optimize treatment and ICU resources, risk prediction for prolonged ICU stay after cardiac surgery using the existing models should be done with great care for older patients.
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Intensive care medicine · Sep 2011
The number of failing organs predicts non-invasive ventilation failure in children with ALI/ARDS.
Non-invasive positive pressure ventilation (NIV) is being increasingly used in paediatric critical care, although its use in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) is still debated. No definite data are available for the prediction of NIV outcome in such selected populations. We aimed to identify which factors might affect NIV failure in paediatric ALI/ARDS patients. ⋯ NOF significantly predicts the NIV failure. Children with no organ failures other than ALI/ARDS may safely be treated with NIV.
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Intensive care medicine · Sep 2011
Concomitant arginine-vasopressin and hydrocortisone therapy in severe septic shock: association with mortality.
To evaluate the association between concomitant arginine-vasopressin (AVP)/hydrocortisone therapy and mortality in severe septic shock patients. ⋯ Concomitant AVP and hydrocortisone therapy may be associated with a survival benefit in septic shock. An adequately powered, randomised controlled trial appears warranted to confirm these preliminary, hypothesis-generating results.
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Intensive care medicine · Sep 2011
Comparative StudyComparison of carbamylated erythropoietin-FC fusion protein and recombinant human erythropoietin during porcine aortic balloon occlusion-induced spinal cord ischemia/reperfusion injury.
Recombinant human erythropoietin (rhEPO) attenuated ischemia/reperfusion (I/R) injury-induced spinal cord damage. Since carbamylated EPO derivatives are stated to be devoid of rhEPO side effects, we tested the hypothesis that a newly developed carbamylated EPO-FC fusion protein (cEPO-FC) would compare favorably with rhEPO. ⋯ In a porcine model of aortic balloon occlusion-induced spinal cord I/R injury, cEPO-FC and rhEPO comparably protected against ischemic spinal cord dysfunction and neuronal damage. This effect coincided with attenuated oxidative stress.