Läkartidningen
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Transcranial Doppler (TCD) sonography, a noninvasive method to record cerebral blood flow velocity, is increasingly being used to predict the development of a delayed ischemic deficit after subarachnoid hemorrhage. Advantages and limitations of the TCD technique in neurosurgical practice are discussed.
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Antithrombin has been used for over two decades as adjuvant therapy in severe sepsis, especially when associated with coagulopathy. A positive effect has been demonstrated in several experimental sepsis models and a number of small clinical trials have suggested a beneficial effect. ⋯ Among various secondary effect and subgroup analyses, it is noteworthy that no trend indicating a beneficial effect of antithrombin substitution was found even in the subgroup of patients with plasma levels of antithrombin < 60% on randomization (n = 1,117). In summary, there is presently no support for the general use of antithrombin as adjuvant therapy in severe sepsis/septic shock.
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Prognostic factors for ICU-patients during and after ICU-discharge are reviewed as well as predisposing factors for readmissions. The overall mortality for ICU-patients are in most studies in the range of 12-32%, with a mortality rate after ICU discharge of 15-35%. ⋯ Readmissions to ICU are not uncommon and usually (45-65%) related to the underlying illness. The use of High Dependency Units or a sufficient ICU capacity might reduce the mortality rate as well as the rate of readmissions.