Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Multicenter Study Observational Study
Incidence, Outcomes and Risk Factors for Mortality of Symptomatic upper Gastrointestinal Hemorrhage in Surgical Critical Ill Patients (THAI SICU Study).
This multicenter university-based study reports the incidence, outcomes and defined risk factors for mortality of upper gastrointestinal hemorrhage (UGIH) patients in the surgical intensive care units (ICU) patients in Thailand. ⋯ The incidence of symptomatic UGIH in the THAI-SICU study was 1.18% and UGIH was associated with higher 28-day mortality rate and prolonged ICU length of stay. The risk factors for mortality were coagulopathy, renal failure, APACHE II score and vasopressor use.
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Multicenter Study Observational Study
Predictors of Prolonged Length of Stay in General Surgical Intensive Care Unit.
The aims of this study were to explore the incidence, clinical factors, severity scores and outcome associated with prolonged length of intensive care unit (ICU) stay >3 days. ⋯ About one-fifth of the study patients had prolonged ICU stay (>3 days). Low preoperative serum albumin (<2.6 mg/dL), low preoperative hematocrit (<34%), ASA physical status class IV, underwent emergency surgery, having anesthetic complications, surgical complications, sepsis on ICU admission, having respiratory support with or without unstable hemodynamic were significantly associated with prolonged ICU stay.
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Observational Study
Central Venous Oxygen Saturation Is not a Predictor of Extubation Success after Simple Weaning from Mechanical Ventilation in Post-Cardiac Surgical Patients.
Central venous oxygen saturation (ScvO2) is a measure of the balance between oxygen delivery and consumption. The purpose of this study was to evaluate whether ScvO2 predict weaning success and extubation in simple weaning postcardiac surgical patients. ⋯ ScvO2 or its combination with RSBI, PF ratio and minute volume does not predict successful weaning from mechanical ventilators and extubation in critically ill post-cardiac surgical patients.
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To determine whether serum venous lactate is associated with an increased risk of septic shock and risk of death in emergency department patients with systemic inflammatory response syndrome (SIRS). ⋯ For patients presenting to the emergency department with clinical symptoms of SIRS, a single serum venous lactate level measurement of greater than 36 mg/dL provides valuable prognostic predictor information concerning the high-risk group likely to progress to septic shock, more serious disease severity, and death.
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Randomized Controlled Trial
Comparative Study of Postoperative Pain between Maylard Incision and Pfannenstiel Incision in Gynecologic Surgery: A Randomized Controlled Trial.
Postoperative pain has many adverse effects for the patients with laparotomy operation. There are few studies that compare between Maylard and Pfannenstiel incision in term of pain and wound complication after operation. ⋯ Postoperative pain up to 48 hours in both Maylard and Pfannenstiel group showed similar VAS but after 48 hours; the Maylard group showed less pain. Even though the surgical wound length in Maylard group was longer than Pfannenstiel group, numbers of cases with VAS >4 within 24 hours in Maylard were less than in Pfannenstiel group. Postoperative pain up to 48 hours in both Maylard and Pfannenstiel group showed similar VAS but after 48 hours; the Maylard group showed less pain. Even though the surgical wound length in Maylard group was longer than Pfannenstiel group, numbers of cases with VAS >4 within 24 hours in Maylard were less than in Pfannenstiel group.