Intensive care medicine
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Intensive care medicine · Jun 2015
Observational StudyOutcomes associated with routine systemic antifungal therapy in critically ill patients with Candida colonization.
To assess the evolution of patient deep colonization by Candida spp. in a surgical ICU over an 8-year period. ⋯ Preemptive strategy of antifungal drug prescriptions in highly colonized ICU patients induced an increase in C. glabrata colonization without significant shift of colonization to other Candida spp. in surgical ICU patients. However, the potential detrimental impact of fluconazole on Candida ecology in ICU and/or on Candida susceptibility to antifungal drugs should be considered, and deserves further studies.
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Intensive care medicine · Jun 2015
Multicenter StudyFeasibility and utility of the use of real time random safety audits in adult ICU patients: a multicentre study.
The two aims of this study were first to analyse the feasibility and utility (to improve the care process) of implementing a new real time random safety tool and second to explore the efficacy of this tool in core hospitals (those participating in tool design) versus non-core hospitals. ⋯ Real time safety audits improved the care process and adherence to the clinical practice guidelines and proved to be most useful in situations of high care load and in patients with more severe disease. The effect was greater in core hospitals.
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Intensive care medicine · Jun 2015
Multicenter StudyMultinational development and validation of an early prediction model for delirium in ICU patients.
Delirium incidence in intensive care unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention. ⋯ Patients' delirium risk for the complete ICU length of stay can be predicted at admission using the E-PRE-DELIRIC model, allowing early preventive interventions aimed to reduce incidence and severity of ICU delirium.
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Intensive care medicine · Jun 2015
Multicenter StudyVisualizing the pressure and time burden of intracranial hypertension in adult and paediatric traumatic brain injury.
To assess the impact of the duration and intensity of episodes of increased intracranial pressure on 6-month neurological outcome in adult and paediatric traumatic brain injury. ⋯ The intracranial pressure-time burden associated with worse outcome is visualised in a colour-coded plot. In children, secondary injury occurs at lower intracranial pressure thresholds as compared to adults. Impaired cerebrovascular autoregulation reduces the ability to tolerate intracranial pressure insults. Thus, 50 mmHg might be the lower acceptable threshold for cerebral perfusion pressure.