Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2008
[Topical aspects of standardization in anesthesiology and intensive care].
Implementation of standards and practice protocols is one of the most challenging problems of anesthesiology and intensive care. Several important issues regarding the process of standards development, their structure, goals, and targets, anticipated results and benefits, as well as clinical and theoretical limitations are discussed. The situation associated with the standardization at the national level is presented with parallel highlighting of future perspectives.
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Anesteziol Reanimatol · Jul 2008
[Etiology of postoperative bacteremias in an intensive care unit: an association with the level of procalcitonin].
The etiology of bacteremia determines the choice of adequate therapy for severe infections. The clinical manifestations of gram-negative and gram-positive bacterial infections are similar while biological markers may serve as a guide for the early diagnosis of the nature of a pathogen. The paper analyzes data on the rate and etiology of bacteremia in 1360 patients at the A. ⋯ In the gram-negative bacteremia group, plasma PCT levels were statistically significantly higher than in the gram-positive bacteremia group (5.40 and 0.86 ng/mg, respectively; p = 0.000000). On constructing a characteristic curve, the authors determined the PCT cut-off value of 5.2 ng/ml for the differential diagnosis of gram-negative and gram-positive bacteremia with the maximum (86%) specificity and more than 50% specificity. Thus, when patients with suspected infections have plasma PCT levels, the leading value of gram-negative microorganisms may be supposed just before obtaining blood culture results.