British journal of anaesthesia
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Editorial Comment
Saving mothers' lives: the 2006-8 anaesthesia perspective.
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The population aged older than 65 yr is set to increase by 32% by 2033. In resource-limited environments, difficult decisions regarding access to high dependency care for the elderly are increasingly important. The aim of this study was to determine whether age is a predictor of mortality in patients admitted to an open medical high dependency unit (MHDU). ⋯ Age does not predict the outcome from an MHDU. Those requiring ≥2 organ support, higher levels of pre-admission home support, or both had higher mortality. Selected elderly medical patients should not be denied high dependency unit care.
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Changes in central venous pressure (CVP) rather than absolute values may be used to guide fluid therapy in critically ill patients undergoing mechanical ventilation. We conducted a study comparing the changes in the CVP produced by an increase in PEEP and stroke volume variation (SVV) as indicators of fluid responsiveness. Fluid responsiveness was assessed by the changes in cardiac output (CO) produced by passive leg raising (PLR). ⋯ Our data in mechanically ventilated, cardiac surgery patients suggest that the newly defined parameter, PEEP-induced CVP changes, like SVV, appears to be a good parameter to predict fluid responsiveness.