Intensive care medicine
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Intensive care medicine · Mar 2014
Access to urban acute care services in high- vs. middle-income countries: an analysis of seven cities.
Cities are expanding rapidly in middle-income countries, but their supply of acute care services is unknown. We measured acute care services supply in seven cities of diverse economic background. ⋯ Urban acute care services vary substantially across economic regions, only partially due to differences in GDP. Cities were poor sources of information, which may hinder their future planning.
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Intensive care medicine · Mar 2014
Multicenter StudyOne-year mortality and predictors of death among hospital survivors of acute respiratory distress syndrome.
Advances in supportive care and ventilator management for acute respiratory distress syndrome (ARDS) have resulted in declines in short-term mortality, but risks of death after survival to hospital discharge have not been well described. Our objective was to quantify the difference between short-term and long-term mortality in ARDS and to identify risk factors for death and causes of death at 1 year among hospital survivors. ⋯ Despite improvements in short-term ARDS outcomes, 1-year mortality is high, mostly because of the large burden of comorbidities, which are prevalent in patients with ARDS.
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Intensive care medicine · Mar 2014
Is the volume of mechanically ventilated admissions to UK critical care units associated with improved outcomes?
It is unknown whether a volume-outcome relationship exists for mechanically ventilated admissions to UK critical care units. This study was conducted to evaluate the volume-outcome relationship for mechanically ventilated admissions to adult, general critical care units in the UK with a view to informing policy, service delivery and organisation of specialist, advanced respiratory care. ⋯ A volume-outcome relationship was demonstrated for mechanically ventilated admissions to adult, general critical care units in the UK. The relationship is sensitive to the modelling approach used.
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Intensive care medicine · Mar 2014
Observational StudyTime course of central venous-to-arterial carbon dioxide tension difference in septic shock patients receiving incremental doses of dobutamine.
To assess the time course of the central venous-arterial carbon dioxide tension difference (∆PCO2)-as an index of the carbon dioxide production (VCO2)/cardiac index (CI) ratio-in stable septic shock patients receiving incremental doses of dobutamine. ⋯ ∆PCO2 is a good indicator of the change of VCO2 induced by dobutamine. Measurement of ∆PCO2, along with ScvO2 and EO2, may be presented as a useful tool to assess the adequacy of oxygen supply versus metabolic and oxygen demand.