Intensive care medicine
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Intensive care medicine · Mar 2015
Review Meta AnalysisImpact of closed versus open tracheal suctioning systems for mechanically ventilated adults: a systematic review and meta-analysis.
Whether closed tracheal suctioning systems (CTSS) reduce the incidence of ventilator-associated pneumonia (VAP) compared with open tracheal suctioning systems (OTSS) is inconclusive. We conducted a systematic review and meta-analysis of randomized controlled trials that compared CTSS and OTSS. ⋯ Based on current, albeit limited evidence, it is unlikely that CTSS is inferior to OTSS regarding VAP prevention; however, further trials at low risk of bias are needed to confirm or refute this finding.
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Intensive care medicine · Mar 2015
Randomized Controlled Trial Multicenter StudyProtocolized fluid therapy in brain-dead donors: the multicenter randomized MOnIToR trial.
Critical shortages of organs for transplantation jeopardize many lives. Observational data suggest that better fluid management for deceased organ donors could increase organ recovery. We conducted the first large multicenter randomized trial in brain-dead donors to determine whether protocolized fluid therapy increases the number of organs transplanted. ⋯ In brain-dead organ donors, protocol-guided fluid therapy compared to usual care may not increase the number of organs transplanted per donor.
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Intensive care medicine · Mar 2015
ICU survivors show no decline in health-related quality of life after 5 years.
Severe critical illness requiring treatment in the intensive care unit (ICU) may have a serious impact on patients and their families. However, optimal follow-up periods are not defined and data on health-related quality of life (HRQOL) before ICU admission as well as those beyond 2 years follow-up are limited. The aim of our study was to assess the impact of ICU stay up to 5 years after ICU discharge. ⋯ After correction for natural decline, the effect sizes of decreases in HRQOL were small, suggesting that patients regain their age-specific HRQOL 5 years after their ICU stay.
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Intensive care medicine · Mar 2015
Randomized Controlled Trial Comparative StudyPreemptive enteral nutrition enriched with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in severe multiple trauma: a prospective, randomized, double-blind study.
Severe injury triggers a complex systemic immune response which may result in significant respiratory compromise, including the development of acute respiratory distress syndrome (ARDS). No randomized clinical trial has assessed the role of nutritional interventions to limit respiratory complications. ⋯ This study failed to show a significant benefit for the preemptive use of the study formula in patients with severe trauma. Additional studies need to be performed in which the amount of supplementation is targeted to a potentially measurable endpoint, e.g. the O-3I.