Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2016
Ventilator-induced central venous pressure variation can predict fluid responsiveness in post-operative cardiac surgery patients.
Ventilator-induced dynamic hemodynamic parameters such as stroke volume variation (SVV) and pulse pressure variation (PPV) have been shown to predict fluid responsiveness in contrast to static hemodynamic parameters such as central venous pressure (CVP). We hypothesized that the ventilator-induced central venous pressure variation (CVPV) could predict fluid responsiveness. ⋯ The use of ventilator-induced CVPV could predict fluid responsiveness similar to SVV and PPV in post-operative cardiac surgery patients.
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Acta Anaesthesiol Scand · Nov 2016
Capnocytophaga canimorsus bacteremia: clinical features and outcomes from a Helsinki ICU cohort.
Capnocytophaga canimorsus is a gram-negative rod capable of causing severe sepsis or septic shock. We studied the characteristics of patients with C. canimorsus bacteremia treated in intensive care unit (ICU). ⋯ Capnocytophaga canimorsus infection may present with severe sepsis or septic shock with organ dysfunction, most frequently coagulopathy and acute kidney injury. Previously recognized risk factors are not always present. A dog in a household may be a sufficient exposure for developing a severe form of the disease. The possibility of C. canimorsus infection should be considered in patients with any contact with dogs, even in immunocompetent patients.
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Acta Anaesthesiol Scand · Nov 2016
Respiratory rates measured by a standardised clinical approach, ward staff, and a wireless device.
Respiratory rate is among the first vital signs to change in deteriorating patients. The aim was to investigate the agreement between respiratory rate measurements by three different methods. ⋯ A concerning lack of agreement was found between a wireless monitoring system and a standardised clinical approach. Ward staff's measurements also seemed to be inaccurate.
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Acta Anaesthesiol Scand · Nov 2016
Standard dosing of piperacillin and meropenem fail to achieve adequate plasma concentrations in ICU patients.
Controversies remain regarding optimal dosing and the need for plasma concentration measurements when treating intensive care patients with beta-lactam antibiotics. ⋯ With standard doses of meropenem and piperacillin-tazobactam, plasma concentrations in ICU patients vary > 10-fold and are suboptimal in a significant percentage of patients. The variation is large also between patients with similar renal function.