Intensive care medicine
-
Intensive care medicine · Apr 2007
Randomized Controlled Trial Multicenter StudyEpidemiology of sepsis in Germany: results from a national prospective multicenter study.
To determine the prevalence and mortality of ICU patients with severe sepsis in Germany, with consideration of hospital size. ⋯ The expected number of newly diagnosed cases with severe sepsis in Germany amounts to 76-110 per 100,000 adult inhabitants. To allow better comparison between countries, future epidemiological studies should use standardized study methodologies with respect to sepsis definitions, hospital size, and daily and monthly variability.
-
Intensive care medicine · Apr 2007
ReviewSystematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward.
Physiological track and trigger warning systems (TTs) are used to identify patients outside critical care areas at risk of deterioration and to alert a senior clinician, Critical Care Outreach Service, or equivalent. The aims of this work were: to describe published TTs and the extent to which each has been developed according to established procedures; to review the published evidence and available data on the reliability, validity and utility of existing systems; and to identify the best TT for timely recognition of critically ill patients. ⋯ A wide variety of TTs were in use, with little evidence of reliability, validity and utility. Sensitivity was poor, which might be due in part to the nature of the physiology monitored or to the choice of trigger threshold. Available data were insufficient to identify the best TT.
-
Intensive care medicine · Apr 2007
Meta AnalysisMeta-regression analysis of high-frequency ventilation vs conventional ventilation in infant respiratory distress syndrome.
There is considerable heterogeneity among randomized trials comparing high-frequency ventilation (HFV) with conventional mechanical ventilation (CMV) in premature neonates with respiratory distress syndrome. We investigated what factors explained differences in outcome among these trials. ⋯ Variation in ventilation strategies that were used in trials comparing HFV with CMV in premature neonates offered the most likely explanation for the observed differences in the outcome of these trials compared with other explanatory factors.
-
Intensive care medicine · Apr 2007
Multicenter StudyRIFLE classification in patients with acute kidney injury in need of renal replacement therapy.
To evaluate the association of RIFLE classification with the outcomes of critically ill patients with acute kidney injury (AKI) who require renal replacement therapy (RRT). ⋯ Older age, number of organ dysfunctions, presence of comorbidities, and reduced functional capacity were the main prognostic factors. Patients who required RRT after the first day of ICU had a worse outcome. The RIFLE classification did not discriminate the prognosis in patients with AKI in need for RRT.