Intensive care medicine
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Intensive care medicine · Dec 2007
ReviewReview of retention strategies in longitudinal studies and application to follow-up of ICU survivors.
To review the literature on retention strategies in follow-up studies and their relevance to critical care and to comment on the Toronto experience with the acute respiratory distress syndrome (ARDS) and severe acute respiratory syndrome (SARS) follow-up studies. ⋯ Strategies to reduce patient attrition are time consuming but necessary to preserve internal and external validity. When the follow-up system is working effectively, researchers can acquire the necessary data to advance knowledge in their field and patients are satisfied that they have an important role to play in the research project.
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Intensive care medicine · Dec 2007
Comparative StudyLack of agreement between thermodilution and electrical velocimetry cardiac output measurements.
The modified algorithm for the non-invasive determination of cardiac output (CO) by electrical bioimpedance-electrical velocimetry (EV)-has been reported to give reliable results in comparison with echocardiography and pulmonary arterial thermodilution (PA-TD) in patients either before or after cardiac surgery. The present study was designed to determine whether EV-CO measurements reflect intraindividual changes in CO during cardiac surgery. ⋯ The disagreement between PA-TD and EV-CO measurements after anesthesia induction and after ICU admission, as well as the fact that thoracic bioimpedance did not adequately reflect pre- to postoperative changes in CO, questions the reliability of EV-CO measurements in cardiac surgery patients and contrasts sharply with previous studies.
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Intensive care medicine · Dec 2007
Comparative StudyAccuracy of bedside capillary blood glucose measurements in critically ill patients.
To compare the accuracy of fingerstick with laboratory venous plasma glucose measurements (laboratory glucose) in medical ICU patients and to determine the factors which interfere with the accuracy of fingerstick measurements. ⋯ The findings suggest that capillary blood glucose as measured by fingerstick is inaccurate in critically ill ICU patients and does not meet the CLSI standard. It is unclear whether the sampling method, device used, or both contributed to this inaccuracy. The wide limits of agreement suggest that fingerstick measurements should be used with great caution in protocols of tight glycemic control.
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Intensive care medicine · Dec 2007
The relationship between blood glucose control and intolerance to enteral feeding during critical illness.
To assess the relationship between blood glucose concentrations (BSL) and intolerance to gastric feeding in critically ill patients. ⋯ Feed intolerance in critically ill patients is associated with a greater degree of glycaemic variation, with a greater number of patients with transient hyperglycaemia. These data suggest more intensive insulin therapy may be required to minimize feed intolerance, an issue that warrants further study.
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Intensive care medicine · Dec 2007
Bactericidal permeability increasing protein gene variants in children with sepsis.
To evaluate the role of genetic polymorphisms of the bactericidal permeability increasing protein (BPI) in pediatric patients with sepsis. ⋯ BPI Taq gene polymorphism is the accurate predictor of the severity of sepsis in children admitted to the PICU.