Medicina intensiva
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Practice Guideline
Crystalloids and colloids in critical patient resuscitation.
Fluid resuscitation is essential for the survival of critically ill patients in shock, regardless of the origin of shock. A number of crystalloids and colloids (synthetic and natural) are currently available, and there is strong controversy regarding which type of fluid should be administered and the potential adverse effects associated with the use of these products, especially the development of renal failure requiring renal replacement therapy. ⋯ This new information has increased uncertainty among clinicians regarding which type of fluid should be used. We therefore have conducted a review of the literature with a view to developing practical recommendations on the use of fluids in the resuscitation phase in critically ill adults.
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Observational Study
Mortality predictive factors in patients with urinary sepsis associated to upper urinary tract calculi.
The aims of this study were to determine the clinical characteristics of patients with urinary sepsis associated to ureteral calculi admitted to the Intensive Care Unit (ICU), and to identify predictors of mortality in the first 24 hours of admission. ⋯ Advanced age, acute renal failure and the need for vasoactive drugs were associated to an increased risk of mortality in patients with urinary sepsis associated to upper urinary tract calculi.
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Multicenter Study Comparative Study Observational Study
Comparative analysis of patients admitted to Spanish Intensive Care Units due to medical and surgical disease.
To describe the characteristics of the patients case-mix admitted to ICUs due to medical and surgical disease, and to compare both groups. ⋯ The mortality rate is higher in non-coronary medical patients, though resource use per patient is greater in the urgent surgery cases. The APACHE II scale underestimates mortality in emergency surgery patients.
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To explore contributing factors (CF) associated to related critical patients safety incidents. ⋯ The CF group more frequently reported were patient factors and was associated to more severe and unavoidable incidents. By contrast, individual factors were associated to less severe and avoidable incidents. In general, CF most frequently reported were associated to near miss.