Crit Care Resusc
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Comparative Study
Hypothermia on arrival in the intensive care unit after surgery.
Minimising perioperative hypothermia is a priority for anaesthetists. However, there are few studies of postoperative hypothermia in intensive care units. We tested the hypotheses that many patients arrive in the ICU with hypothermia and that patients are warmer after cardiac surgery than after non-cardiac surgery. ⋯ Hypothermia is common among postoperative patients admitted to our ICU. We suggest that ICU staff should routinely expect to actively warm postoperative patients, particularly after non-cardiac surgery, and should have sufficient resources to do so.
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It is often assumed that critical care outcomes in the elderly are uniformly poorer than those in younger populations. We examined the pattern of admissions to our intensive care unit in Dublin, Ireland, between 2002 and 2005 to determine the admission characteristics and mortality in those aged 80 years and older. ⋯ The nature of the admission and severity of illness, but not age, are determinants of ICU survival. Evidence-based criteria are needed to assess the appropriateness of ICU admission in the very elderly. Clear criteria would help to prevent initiation of futile therapies and also to ensure that the very elderly are not denied potentially beneficial ICU care. We need to study triage patterns and outcome data further to ensure that the very elderly have the same opportunities to access appropriate intensive care treatment as the rest of the population.
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To review the indications for admission, demographics, clinically relevant aspects of medical care and outcomes of critically ill obstetric patients admitted to a tertiary hospital intensive care unit. ⋯ This audit is a reminder that continued vigilance is required to ensure maternal safety. It also emphasises the need to integrate free-standing maternity units with hospital intensive care services.
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Severe septicaemia secondary to melioidosis carries a high mortality. Although melioidosis can involve most tissues and organs, pericardial involvement is rare. ⋯ This is the first case in Australia or New Zealand of melioid sepsis presenting with pericarditis and subsequent cardiac tamponade. We review the literature on cardiac involvement in melioidosis.