Intensive care medicine
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The proportion of elderly patients admitted to the ICU is increasing. Mortality rates are known to increase with age but the impact of age on outcomes after circulatory shock has not been well defined. ⋯ Ageing is independently associated with higher mortality rates in patients with circulatory failure, whatever the etiology. By 1 year after admission, most patients 85 years of age and older were dead.
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Intensive care medicine · Jan 2014
Impact of improvement in preoperative oral health on nosocomial pneumonia in a group of cardiac surgery patients: a single arm prospective intervention study.
To evaluate the effects of an oral health protocol on the incidence of postoperative pneumonia in patients submitted to coronary artery bypass grafting and to valve surgery. ⋯ PP rates were reduced using a simple and efficient protocol of dental care that improved oral hygiene in the preoperative period of cardiac surgery patients.
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Intensive care medicine · Jan 2014
Determination of the learning curve for ultrasound-guided jugular central venous catheter placement.
Use of ultrasound (US) when introducing central venous catheters (CVC) may improve success rates, reduce the number of needle punctures, and decrease complication rates, but has been hampered by supposed difficulty in learning how to perform the technique. This study describes the learning curve for US-guided jugular CVC placement after a training program. ⋯ Our study demonstrates that skills in US-guided CVC placement can easily be acquired with training.
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Intensive care medicine · Jan 2014
Comparative StudyImproved clinical and economic outcomes in severe bronchiolitis with pre-emptive nCPAP ventilatory strategy.
Severe bronchiolitis is the leading cause of admission to the pediatric intensive care unit (PICU). Nasal continuous positive airway pressure (nCPAP) has become the primary respiratory support, replacing invasive mechanical ventilation (MV). Our objective was to evaluate the economic and clinical consequences following implementation of this respiratory strategy in our unit. ⋯ nCPAP in severe bronchiolitis is associated with a significant improvement in patient management as shown by the reduction in invasive care, LOV, PICU LOS, hospital LOS, and economic burden.