Intensive care medicine
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Intensive care medicine · Aug 2015
Review Meta AnalysisEndogenous IgG hypogammaglobulinaemia in critically ill adults with sepsis: systematic review and meta-analysis.
Plasma immunoglobulin concentrations are acutely altered in critically ill patients with sepsis. However, the association between immunoglobulin levels on the day of sepsis diagnosis and subsequent mortality is inconsistent. ⋯ This systematic review identifies studies of limited quality reporting heterogeneous sepsis cohorts with varying lower limits of normal for IgG. Although our data suggest that a subnormal IgG measurement on the day of sepsis diagnosis does not identify a subgroup of patients with a higher risk of death, further studies are needed to confirm or refute this finding, and whether optimal cut-offs and time windows can be defined for IgG measurement. This would determine whether patients receiving intravenous immunoglobulin therapy for sepsis could be stratified using IgG levels.
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Intensive care medicine · Aug 2015
Multicenter StudyCost awareness of physicians in intensive care units: a multicentric national study.
Physicians play an important role in strategies to control health care spending. Being aware of the cost of prescriptions is surely the first step to incorporating cost-consciousness into medical practice. The aim of this study was to evaluate current intensivists' knowledge of the costs of common prescriptions and to identify factors influencing the accuracy of cost estimations. ⋯ ICU physicians have a poor awareness of prescriptions costs, especially with regards to high-cost drugs. Considerable emphasis and effort are still required to integrate the cost-containment problem into the daily prescriptions in ICUs.
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Intensive care medicine · Aug 2015
Early fluid accumulation in children with shock and ICU mortality: a matched case-control study.
The purpose of this study was to evaluate the association between early fluid accumulation and mortality in children with shock states. ⋯ The presence, severity and duration of early fluid are associated with increased ICU mortality in children admitted to the pediatric ICU in shock states.
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Intensive care medicine · Aug 2015
Observational Studyβ-D-Glucan and Candida albicans germ tube antibody in ICU patients with invasive candidiasis.
To assess the performance of (1→3)-β-D-glucan (BDG) and Candida albicans germ tube antibody (CAGTA) for the diagnosis of invasive candidiasis (IC) in a prospective cohort of 107 unselected, non-neutropenic ICU patients. ⋯ Two consecutive BDG levels ≥80 pg/mL allowed discrimination among IC and high-grade colonization. Systemic antifungal therapy could not be monitored with biomarker kinetics, and BDG levels were not subject to interference by confounding factors in either colonized or infected patients or with low-grade colonization.
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Intensive care medicine · Aug 2015
Physical activity, muscle strength, and exercise capacity 3 months after severe sepsis and septic shock.
To quantify the physical activity in daily life (PADL), muscle strength, and exercise capacity in the short and medium term in survivors of severe sepsis and septic shock. ⋯ Our results suggest that survivors of sepsis admitted to the ICU have a substantial reduction in physical activity, exercise capacity, and muscle strength compared to healthy subjects that persist even 3 months after hospital discharge.