Intensive care medicine
-
Intensive care medicine · Mar 2017
Review Practice Guideline Meta Analysis Comparative StudyEarly enteral nutrition in critically ill patients: ESICM clinical practice guidelines.
To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. ⋯ We suggest using EEN in the majority of critically ill under certain precautions. In the absence of evidence, we suggest delaying EN in critically ill patients with uncontrolled shock, uncontrolled hypoxaemia and acidosis, uncontrolled upper GI bleeding, gastric aspirate >500 ml/6 h, bowel ischaemia, bowel obstruction, abdominal compartment syndrome, and high-output fistula without distal feeding access.
-
Intensive care medicine · Mar 2017
Randomized Controlled Trial Multicenter StudyVenous thromboembolic events in critically ill traumatic brain injury patients.
To estimate the prevalence, risk factors, prophylactic treatment and impact on mortality for venous thromboembolism (VTE) in patients with moderate to severe traumatic brain injury (TBI) treated in the intensive care unit. ⋯ Despite mechanical and pharmacological prophylaxis, VTE occurs in one out of every five patients with TBI treated in the ICU. Higher age, greater weight and greater severity of TBI increase the risk. The development of VTE was not associated with excess mortality.
-
Intensive care medicine · Mar 2017
Multicenter StudyLate-onset moderate to severe acute respiratory distress syndrome is associated with shorter survival and higher mortality: a two-stage association study.
To evaluate the association between acute respiratory distress syndrome (ARDS) onset time and prognosis. ⋯ Late-onset moderate to severe ARDS patients had both shorter survival time and higher mortality rate in 28-day and 60-day observations.
-
Intensive care medicine · Mar 2017
Randomized Controlled TrialEffects of neuromuscular blockers on transpulmonary pressures in moderate to severe acute respiratory distress syndrome.
To investigate whether neuromuscular blocking agents (NMBA) exert beneficial effects in acute respiratory distress syndrome (ARDS) by reason of their action on respiratory mechanics, particularly transpulmonary pressures (P L). ⋯ NMBA could exert beneficial effects in patients with moderate ARDS, at least in part, by limiting expiratory efforts.