Articles: intensive-care-units.
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Observational Study
Short-term mortality of patients ≥80 years old admitted to European intensive care units: an international observational study.
Limited evidence suggests variation in mortality of older critically ill adults across Europe. We aimed to investigate regional differences in mortality among very old ICU patients. ⋯ The apparent variation in short-term mortality rates of older adults hospitalised in ICUs across Europe can be largely attributed to differences in the clinical profile of patients admitted. The volume-outcome relationship identified in this population requires further investigation.
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Sepsis is a highly prevalent cause of death in intensive care units. Characterized by severe immune cell derangements, sepsis is often associated with multiorgan dysfunction. For many sepsis survivors, these deficits can persist long after clinical resolution of the underlying infection. ⋯ In addition to proportional cell composition changes, acute sepsis induced significant transcriptional alterations in most immune cell types analyzed-changes that failed to completely resolve 1 month after sepsis. Taken together, we report widespread and persistent transcriptional changes in diverse immune cells in response to polymicrobial infection. This study will serve as a valuable resource for future work investigating acute and/or long-term sepsis-associated immune cell derangements.
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Case Reports
Bedside Diagnosis of Pulmonary Embolism Using Electrical Impedance Tomography: A Case Report.
Electrical impedance tomography (EIT) is an emerging imaging modality that can be used to diagnose ventilatory and intrathoracic perfusion mismatches in unstable patients at the bedside. We present a case of a postoperative hypoxic patient in the intensive care unit (ICU) who was too unstable for transport for computed tomography (CT) imaging but was diagnosed and treated for a pulmonary embolism using EIT at the bedside. After the patient clinically improved, CT imaging confirmed the pulmonary embolism diagnosis. EIT is a promising diagnostic tool that may have great utility in ICUs, where it can be safely applied at the bedside.
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Intensive care unit follow-up clinics are becoming an increasingly widespread intervention to facilitate the physical, cognitive, psychiatric, and social rehabilitation of survivors of critical illness who have post-intensive care syndrome. Developing and sustaining intensive care unit follow-up clinics can pose significant challenges, and clinics need to be tailored to the physical, personnel, and financial resources available at a given institution. Although no standard recipe guarantees a successful intensive care unit aftercare program, emerging clinics will need to address a common set of hurdles, including securing an adequate space; assembling an invested, multidisciplinary staff; procuring the necessary financial, information technology, and physical stuff; using the proper screening tools to identify patients most likely to benefit and to accurately identify disabilities during the visit; and selling it to colleagues, hospital administrators, and the community at large.