Medicina intensiva
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Review Comparative Study
[Result of extubation after spontaneous breathing test with automatic tube compensation versus continuous positive airway pressure].
The gold standard test to evaluate the readiness of a patient to be extubated is a spontaneous breathing trial. This trial is performed either using the T-piece disconnected from the ventilator, either using a low level of pressure support, with or without positive end-expiratory pressure. ⋯ A major goal to liberate the patient from the ventilator is to recognize the readiness for extubation as soon and as reliably as possible. The stop of sedation and the performance of a spontaneous breathing trial daily diminish the duration of mechanical ventilation due to the recognition of the patient's capability of breathing spontaneously.
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Anemia is a common condition among medical and surgical patients admitted to the intensive care unit (ICU) and generally has a multifactorial origin. In order to avoid the deleterious effects of anemia, 40% of ICU patients receive allogenic blood transfusion (ABT). ⋯ In contrast, the administration of exogenous erythropoietin plus iron supplements, especially iv iron, improves anemia and reduces ABT requirements, although it does not reduce mortality. To ascertain whether treatment of anemia in the critically ill with exogenous erythropoietin and iron might improve outcomes and to optimize drug administration schedules and dosage, further studies with sufficient statistical power and adequate follow-up are warranted.
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Multicenter Study Comparative Study
[Non-invasive evaluation of pulmonary artery occlusion pressure in critically ill patients with mechanical ventilation].
To compare the measurements of pulmonary artery occlusion pressure (PAOP) by means of the use a pulmonary artery catheter and those obtained through a formula that relates the systolic artery pressure before and after a Valsalva maneuver. ⋯ The prediction of the PAOP by means of the Valsalva maneuver showed a limited correlation with that obtained by means of the pulmonary artery catheter.
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Analyze the utility and safety of MARS therapy applied with the CRRT monitor. ⋯ The MARS system applied by CRRT monitors provide adequate bilirubin clearance percentages and is safe, even in serious patients. Prolongation of the duration of the sessions was not accompanied by an increase in the risk of infection secondary to the albumin contamination.
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Intermediate Care Units are forms to provide health care services to potentially critical patients that allow for improved cost-benefit ratio of the care offered by Intensive Medicine Departments. ⋯ Initiating an intermediate care unit depending on an IMD increases its health care capacity and that of the center it gives service to without affecting global mortality.