Critical care medicine
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Critical care medicine · Jan 2015
ReviewCardiac Output Monitoring: A Contemporary Assessment and Review.
An increasing number of minimally or noninvasive devices are available to measure cardiac output in the critical care setting. This article reviews the underlying physical principles of these devices in addition to examining both animal and human comparative studies in an effort to allow clinicians to make informed decisions when selecting a device to measure cardiac output. ⋯ Thermodilution is relatively accurate for cardiac output measurements in both animals and humans when compared to experimental reference standards. Doppler-based techniques appear to have similar accuracy as thermodilution pulmonary artery catheters. Bioimpedance, pulse contour, partial rebreathing, and pulse wave velocity-based devices have not been studied as rigorously; however, the majority of studies included in this analysis point towards decreased accuracy.
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Critical care medicine · Jan 2015
Abdominal Paracentesis Drainage Ahead of Percutaneous Catheter Drainage Benefits Patients Attacked by Acute Pancreatitis With Fluid Collections: A Retrospective Clinical Cohort Study.
The efficacy and safety of ultrasound-guided abdominal paracentesis drainage ahead of percutaneous catheter drainage as the new second step of a step-up approach are evaluated. ⋯ Application of abdominal paracentesis drainage ahead of percutaneous catheter drainage is safe and beneficial to patients by reducing inflammatory factors, postponing further interventions, and delaying or avoiding multiple organ failure.
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Critical care medicine · Jan 2015
Surviving Sepsis Campaign: Association Between Performance Metrics and Outcomes in a 7.5-Year Study.
To determine the association between compliance with the Surviving Sepsis Campaign (SSC) performance bundles and mortality. ⋯ This analysis demonstrates that increased compliance with sepsis performance bundles was associated with a 25% relative risk reduction in mortality rate. Every 10% increase in compliance and additional quarter of participation in the SSC initiative was associated with a significant decrease in the odds ratio for hospital mortality. These results demonstrate that performance metrics can drive change in clinical behavior, improve quality of care, and may decrease mortality in patients with severe sepsis and septic shock.
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Critical care medicine · Jan 2015
Pregnancy-Related ICU Admissions in France: Trends in Rate and Severity, 2006-2009.
To determine the national rate per delivery of pregnancy-related ICU admissions of women in France, the characteristics and severity of these cases, and their trends over the 4-year study period. ⋯ The rate of women with pregnancy-related ICU admissions decreased and the severity of their cases increased. Most ICU admissions remained related to the least severe conditions. This raises the issue of the most appropriate organization of care for women with pregnancy-related conditions who require continuous surveillance but not necessarily intensive care.