Crit Care Resusc
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Readmission to intensive care during the same hospital stay has been associated with a greater risk of in-hospital mortality and has been suggested as a marker of quality of care. There is lack of published research attempting to develop clinical prediction tools that individualise the risk of readmission to the intensive care unit during the same hospital stay. ⋯ We have developed a practical clinical tool to individualise the risk of readmission to the ICU during the same hospital stay in patients who survive an initial episode of intensive care.
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Critically ill patients are exposed to a combination of insults that affect both respiratory and peripheral skeletal muscle function. However, different muscle groups may not be affected to the same extent by a prolonged critical illness. ⋯ Currently available bedside methods of measuring respiratory and peripheral muscle function in critically ill patients are somewhat inadequate. Yet there is evidence suggesting that respiratory muscles may be relatively spared from the damage that can occur as a result of immobility, prolonged mechanical ventilation and systemic inflammation in critical illness.
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Inverted tako-tsubo cardiomyopathy (TTC) is a variation of stress cardiomyopathy. It features transient myocardial dysfunction characterised by a typical contractile abnormality consisting of extensive left ventricular circumferential dyskinesia or akinesia with a hyperkinetic apex. ⋯ The patient made a full recovery. Our case highlights that a reversible inverted TTC may result from an exogenous catecholamine surge.
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To identify intensive care patients dying within 2 years of discharge from hospital and assess whether the cause of death was related to the diagnosis at hospital discharge. ⋯ Survival rates of ICU patients after discharge from hospital are high. Deaths are closely related to the discharge diagnosis only in the first 6 months after discharge. Cancer is a common cause of death. Elective non-cardiac surgical patients have the worst outcomes.