Medicina intensiva
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Analyze the clinical usefulness of lactate clearance (CL6) immediately after admission to the intensive care unit (ICU) in the first 6 hours. ⋯ In critically ill surgical patients, whose CL6 on admission was over 2 mEq/l, lactate clearance in the first six hours could be useful to predict the ICU outcome.
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The low cardiac output syndrome following cardiopulmonary bypass is characterized by poor left ventricular contractibility that requires the support of high doses of vasoactive drugs, intra-aortic balloon pump, and sometimes makes it impossible to disconnect the extracorporeal circulation. We report 5 cases in which a "recently created" device in left ventricular support was inserted, the Impella Recover (Impella CardioSystems AG, Aachen, Germany) due to cardiogenic shock at the end of the surgery. Four of these patients recovered their heart function and the ventricular support could be removed after 70+/-55 h. In a fifth patient, the right ventricular failure warranted the use of Berlin Heart assist device.
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Multicenter Study
[Use of non-invasive ventilation in acute respiratory failure. Multicenter study in intensive care units].
Study the use of non-invasive ventilation (NIV) in patients with acute respiratory failure in intensive care units (ICUs) in Spain. ⋯ In Spain, NIV is widely used but it may continue to be underused in COPD and APE. The diagnosis of pneumonia or ARDS was an independent predictive risk factor. Admission in an ICU with NIV in more than 50 patients/year also have higher PaO2/FiO2 ratio after one hour of ventilation were predictive factors of success.