Medicina intensiva
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Induced hypothermia in neurocritical patients is one of the most promising neuroprotective therapies in the last decade. Unfortunately, the promising results obtained in experimental studies have had an unequal reflection in the different diseases that affect the neurocritical patient. The use of therapeutic hypothermia is clearly established in patients with neurological deterioration after cardiac arrest. ⋯ Induced hypothermia has a role in the intensive care unit. Critical care physicians should be familiar with the physiologic effects, current indications, techniques, and complications of induced hypothermia. This review elaborates on the clinical implications of hypothermia research in traumatic brain injury, anoxic, brain injury, stroke and intracerebral hemorrhage.
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The echocardiography can provide important and relevant information and the critically ill patient presents a challenge for the echocardiographer: from limitations in image acquisition to interpretation in the context of rapid physiological and intervention changes. The most frequent reason for requesting an echocardiogram in the ICU is probably to assess left ventricular function. ⋯ The echocardiography also can be used to monitor the therapeutic interventions. The applications of echocardiography in the critical care setting are reviewed, with special emphasis on the assessment of cardiac physiology.
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Comparative Study
[Changes in health-related quality of life after ICU according to diagnostic category. Comparison of two measurement instruments].
Assessment of health related quality of life (HRQOL) before and 12 months after discharge from a mixed intensive care unit (ICU) according to diagnostic category and the relationship between both instruments. ⋯ HRQOL assessment of ICU patients must be done according to a diagnostic category. Both instruments (the EQ-5D and SF-36) are capable of detecting changes in HRQOL. Despite differences in structure and content, both measure similar aspects of quality of life.
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To determine the incidence of the detection of abuse drugs in severe trauma patients ⋯ The high proportion of positive results to toxic substances in severely traumatized patients suggests that the epidemiological environment for these patients is of great concern. These data may be of interest for the design of future prevention campaign.
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Understanding the information provided to families and surrogates of the critically ill patients admitted to ICUs and its adequate communication without contradictions, is a fundamental aspect related with the possible participation of these persons in the treatment decision making and with the quality perceived regarding the care process. Our aim in this study is to assess these two aspects (information and communication of information). ⋯ The analysis of the questionnaire reveals the great heterogeneity of the contents and modes of information provided. This may cause difficulties in understanding and the integration of families and relatives in the care process. The agreement achieved among the different between physicians to facilitate the information and avoid subjective interpretations by the informed people is presented.