Intensive care medicine
-
Intensive care medicine · Nov 2014
The assessment of transpulmonary pressure in mechanically ventilated ARDS patients.
The optimal method for estimating transpulmonary pressure (i.e. the fraction of the airway pressure transmitted to the lung) has not yet been established. ⋯ Based on our observations, elastance-derived transpulmonary pressure can be considered to be an adequate surrogate of the release-derived transpulmonary pressure, while the release-derived and directly measured end-expiratory transpulmonary pressure are not related.
-
Intensive care medicine · Nov 2014
Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study.
To determine the association between compliance with the Surviving Sepsis Campaign (SSC) performance bundles and mortality. ⋯ This analysis demonstrates that increased compliance with sepsis performance bundles was associated with a 25% relative risk reduction in mortality rate. Every 10% increase in compliance and additional quarter of participation in the SSC initiative was associated with a significant decrease in the odds ratio for hospital mortality. These results demonstrate that performance metrics can drive change in clinical behavior, improve quality of care, and may decrease mortality in patients with severe sepsis and septic shock.
-
Intensive care medicine · Nov 2014
The impact of using estimated GFR versus creatinine clearance on the evaluation of recovery from acute kidney injury in the ICU.
To quantify the error in evaluating recovery from acute kidney injury (AKI) with estimated GFR (eGFR) in relation to ICU stay. ⋯ Compared to Clcr, discharge eGFR results in overestimation of renal recovery in patients with prolonged ICU stay and in reduced accuracy of "CKD staging". Since age, gender and race do not change during ICU stay the same conclusion can be drawn with regard to plasma creatinine.