Medicina intensiva
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Recently, dobutamine stress echocardiography [DSE] has been used to study the cardiovascular response in patients with septic shock. The increase in stroke volume index after DSE was seen to be strongly correlated to survival. However, its effect on the tissue Doppler imaging [TDI] values in patients with septic shock was not well established. In this study we investigated the effect of DSE on TDI values as a predictor of norepinephrine weaning and mortality in patients with septic shock. ⋯ Variations in TDI after DSE were able to predict survival in septic shock patients, with an s' wave stress-rest change of >4cm/s being associated to lower ICU mortality, while a cutoff value >2cm/s was associated to better norepinephrine weaning.
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Observational Study
Pretransplant predictors of early mortality in adult recipients of liver transplantation in the MELD-Na Era.
To identify pretransplant predictors of early mortality (90 days after transplantation) and evaluate their discriminating capacity in adult liver transplant recipients (LTR). ⋯ In LTR due to decompensated cirrhosis, the MELD-Na score, age > 60 years, and height < 163cm are independent predictors of early mortality. These factors provide a better classification model than the MELD-Na score for early post-transplant mortality.
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The humanization of care emerges as a response to something that seems indisputable: the scientific and technological developments in Intensive Care Units. Such development has improved the care of the critically ill patient in quantitative terms, but has perhaps caused the emotional needs of patients, families and professionals to be regarded as secondary concerns. The humanization of healthcare should be discussed without confusing or discussing the humanity displayed by professionals. In this paper we review and describe the different strategic lines proposed in order to secure humanized care, and adopt a critical approach to their adaptation and current status in the field of pediatric critical care.