Intensive care medicine
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Intensive care medicine · Jul 2015
Acute kidney injury after out-of-hospital cardiac arrest: risk factors and prognosis in a large cohort.
Characteristics of acute kidney injury (AKI) occurring after out-of-hospital cardiac arrest (OHCA) are incompletely described. We aimed to evaluate the prevalence of AKI, identifying risk factors and assessing the impact of AKI on outcome after OHCA. ⋯ AKI stage 3 was frequent after OHCA and was associated with poorer outcome. Improvement strategies in post-resuscitation care should consider AKI as a potential target of treatment.
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Intensive care medicine · Jul 2015
Comparative StudyUnplanned extubation in a paediatric intensive care unit: prospective cohort study.
Unplanned extubation (UE) is an important paediatric intensive care unit (PICU) quality indicator. Studies on UE have been modest in size, with accurate UE rate calculation potentially hampered by ventilation episodes recorded in calendar days. We wished to document UE rates, outcomes, associated factors and quantify error when calendar days rather than exact timings are used. ⋯ This study provides contemporaneous UE rates for benchmarking. Recording ventilation in calendar days underestimates UE rate. Several factors associated with UE may serve as a focus of quality improvement.
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Intensive care medicine · Jul 2015
Clinical and imaging factors associated with severe complications of cervical necrotizing fasciitis.
Cervical necrotizing fasciitis (CNF) is a severe and debilitating disease that requires intensive care unit (ICU) management and prompt surgical treatment to reduce morbidity and mortality. The aim of this study was to estimate the incidence and factors associated with severe complications of CNF. ⋯ Our study demonstrated that an initial cervico-thoracic CT scan revealed a high incidence of cervical and mediastinal CNF complications that all needed immediate management. Those severe complications might be avoidable as they were associated, at least partially, with prehospital oral glucocorticoid intake.
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Intensive care medicine · Jul 2015
Effects of fluid administration on arterial load in septic shock patients.
To determine the effects of fluid administration on arterial load in critically ill patients with septic shock. ⋯ Fluid administration significantly reduced arterial load in critically patients with septic shock and acute circulatory failure, even when increasing cardiac output. This explains why some septic patients increase their cardiac output after fluid administration without improving blood pressure.