Medicina intensiva
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Mechanical ventilation is associated with important complications, among which production or perpetuation of acute lung injury and product of distant organ injuries of the lung basically through the release of inflammatory mediators to the systemic circulation. There is increasingly greater evidence in both in vitro and in vivo experimental models that show the reality of this lesional mechanism. ⋯ Studies on the use of protective lung ventilation strategies have shown a beneficial effect in patients with ARDS of the use of open lung ventilation strategies, use of circulating volumes less than 10 ml/kg and of maintaining alveolar pressure under 30 cm of H2O. It should be investigated if these same strategies would be useful in preventing the appearance of ARDS in mechanically ventilated patients for another reason, basically in those with risk factors for the development of this condition.
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Multicenter Study
[National Study of Control of Nosocomial Infection in Intensive Care Units. Evolutive report of the years 2003-2005].
Describe the national rates of acquired invasive device-related infections in the ICU during 2003, 2004 and 2005, their etiology and evolution of the multiresistance markers. ⋯ Elevated rates persist in all the infections controlled, without change in the etiology and increase of resistance of gram-negative bacilli.
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Intermediate Care Units are created for patients who predictably have low risk of requiring therapeutic life support measures but who require more monitoring and nursing cares than those received in the conventional hospitalization wards. Previous studies have demonstrated that Intermediate Care Units may promote hospital care grading, allowing for better classification in critical patients, improving efficacy and efficiency of the ICUs and thus decreasing costs and above all mortality in the conventional hospitalization wards. This document attempts to group the currently existing knowledge that served as a base for the consensus meeting on the application of them in the establishment of future ICUs in our hospital setting.