Medicina intensiva
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Multicenter Study Observational Study
Relationship between mortality and first-day events index from routinely gathered physiological variables in ICU patients.
To test the hypothesis that the degree and duration of alterations in physiological variables routinely gathered by intensive care unit (ICU) monitoring systems during the first day of admission to the ICU, together with a few additional routinely recorded data, yield information similar to that obtained by traditional mortality prediction systems. ⋯ A prognostic index with performance very similar to that of habitual systems can be constructed from routine ICU data with only a few patient characteristics. These results may serve as a guide for the possible automated construction of ICU prognostic indexes.
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Acute renal damage (ARD) is a frequent syndrome in hospitalized patients. It is well accepted that ARD susceptibility and outcome are related to environmental risk factors and to the patient premorbid status. Recently, host factors have also been recognized as important in ARD predisposition and evolution. ⋯ ARD susceptibility and severity is influenced by genetic factors, which are multiple and involve different physiopathological mechanisms.
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Multicenter Study
[Impact of noninvasive ventilation failure upon patient prognosis. Subanalysis of a multicenter study].
Noninvasive ventilation (NIV) constitutes first-line treatment for the exacerbation of obstructive pulmonary disease and cardiogenic lung edema. Several studies suggest that NIV failure could increase the risk of mortality, mainly due to the delay in tracheal intubation. We aimed to evaluate the negative impact of NIV failure in routine practice among Spanish ICUs. ⋯ NIV failure and the need of intubation as routinely used do not seem to imply a poorer patient prognosis.
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Observational Study
[Hemodynamic and antipyretic effects of paracetamol, metamizol and dexketoprofen in critical patients].
The objective was to study the antipyretic and hemodynamic effects of three different drugs used to treat fever in critically ill patients. ⋯ Dexketoprofen was the most effective antipyretic agent at the doses tested. Although all three drugs reduced mean arterial pressure, the reduction with paracetamol was less pronounced.
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Flexible bronchoscopy (FB) has been of great help in the management of critically ill patients. Its safety and usefulness in the hands of experienced professionals, with the required measures of caution, has resulted in the increasingly widespread use of the technique even in unstable critical patients subjected to mechanical ventilation and with high oxygen demands. ⋯ The accreditation process seeks to stimulate good learning practice and quality in training. Both specialists in Intensive Care Medicine and other specialists, and the patients, will benefit from the commitment and control afforded by such accreditation, and from the learning and training which the mentioned process entails.