Critical care : the official journal of the Critical Care Forum
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Comparative Study Clinical Trial
Conventional or physicochemical approach in intensive care unit patients with metabolic acidosis.
Metabolic acidosis is the most frequent acid-base disorder in the intensive care unit. The optimal analysis of the underlying mechanisms is unknown. ⋯ Multiple underlying mechanisms are present in most intensive care unit patients with a metabolic acidosis. These mechanisms are reliably determined by measuring the lactate-corrected and albumin-corrected anion gap. Calculation of the more time-consuming strong ion gap according to Stewart is therefore unnecessary.
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Comparative Study
Severe sepsis: variation in resource and therapeutic modality use among academic centers.
Treatment of severe sepsis is expensive, often encompassing a number of discretionary modalities. The objective of the present study was to assess intercenter variation in resource and therapeutic modality use in patients with severe sepsis. ⋯ These data demonstrate moderate but significant variation in resource use and use of technologies in treatment of severe sepsis among academic centers. Delay in antibiotic therapy was associated with worse outcome at the center level.