Articles: cations.
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Fluid responsiveness is proposed as a physiology-based method to titrate fluid therapy based on preload dependence. The objectives of this study were to determine if a fluid responsiveness protocol would decrease progression of organ dysfunction, and a fluid responsiveness protocol would facilitate a more aggressive resuscitation. ⋯ In this study of a "preshock" population, there was no change in progression of organ dysfunction with a fluid responsiveness protocol. A noninvasive fluid responsiveness protocol did facilitate delivery of an increased volume of fluid. Additional properly powered and enrolled outcomes studies are needed.
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To evaluate the safety and efficacy of transversus abdominis muscle release (TAR) with retrorectus synthetic mesh reinforcement in a large series of complex hernia patients. ⋯ Complex AWR represents a formidable surgical challenge. In this large series, we demonstrated that posterior component separation via TAR with wide synthetic mesh sublay provides a very durable repair with low morbidity, even in comorbid patients with large defects. We strongly advocate TAR as a robust addition to the armamentarium of reconstructive surgeons.
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It became increasingly necessary to rethink the value and clinical implication of traumatic brain injury (TBI) management guided by intracranial pressure (ICP) monitoring. ⋯ There were multiple differences between the ICP monitoring and no ICP monitoring groups regarding patient characteristics, injury severity, characteristics of CT scan, and hospital type. ICP monitoring in conjunction with ICP targeted therapies is significantly associated with lower mortality in some special TBI subgroups.