Articles: critical-illness.
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Rev Esp Anestesiol Reanim · Dec 1996
[Succinylcholine induces hyperpotassemia in patients in critically ill patients].
To study changes in kalemia caused by succinylcholine administration to patients in critical care, and the possible association of succinylcholine with clinical and analytical data, severity-of-disease classification, duration of stay in the intensive care unit (ICU) and immobility. ⋯ The use of succinylcholine in critically ill patients causes a brief but significant increase in kalemia, with slight and rare electrocardiographic changes. The effect varies according to the length of time spent in the ICU and the degree of immobility, with maximum increases seen when the ICU stay is between 10 and 30 days. Patient immobility may play an important pathophysiological role. The indications for use of succinylcholine in critically ill patients should be very strict, particularly during the period of greatest sensitivity.
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Intensive care medicine · Dec 1996
Measuring health and health state preferences among critically ill patients.
a) to examine the EuroQol instrument's ability to assess a patient's state of health prior to admission to an ICU; b) to describe a patient's health-related quality of life (HRQoL) before the onset of the condition leading to admission to the ICU, and prior to discharge; c) to compare patients' preferences for a "common core" of EuroQol health states with preferences from healthy individuals. ⋯ The EuroQol can be reliably used with proxies to determine the state of health of patients prior to admission to the ICU. Preferences between healthy individuals and ICU patients differed.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of subcutaneous tunneling on internal jugular catheter-related sepsis in critically ill patients: a prospective randomized multicenter study.
To evaluate the effect of catheter tunneling on internal jugular catheter-related sepsis in critically ill patients. ⋯ The incidence of internal jugular catheter-related infections in critically ill patients can be reduced by using subcutaneous tunnelization.
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Eight patients with severe sepsis, four with septic shock, and eight without sepsis were studied to investigate whether skeletal muscle influences the whole body O2 consumption (VO2)-O2 delivery relationship and hemodynamics. A forearm VO2-O2 delivery dependency was observed only in nonseptic patients, in whom no whole body VO2-O2 delivery dependency appeared. ⋯ Neither a relationship between forearm VO2 and whole body VO2 nor between FAR and SVR was found in any groups of patients. Septic shock was associated with low FAR that was not affected by the FBF decrease, indicating that in this condition, hemodynamics could be influenced by skeletal muscle resistance.
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Multicenter Study
Application of total body bioimpedance to the critically ill patient. Brazilian Group for Bioimpedance Study.
In the past several years, considerable interest has developed in the study of total body bioimpedance analysis (TBBIA) and body composition in healthy subjects. This simple and noninvasive technique uses derived and regression equations to validate data comparative to the gold standards of total body water determination and body composition. However, this approach has not proved to be of value in the critically ill patient with distorted body composition under the effects of multiple drugs and interventions. ⋯ Some authors have demonstrated that this relation Xc/R is highly correlated with mortality and could be used for the staging of critically ill patients throughout their stay in the ICU. The role of TBBIA as a simple and noninvasive technique, and its implications for the management of critically ill patients are presented and discussed. Areas for future investigations, with single and multiple frequency, have the potential to clarify many aspects of this emergent technology at the bedside.