Intensive care medicine
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Intensive care medicine · Jun 2008
Randomized Controlled Trial Comparative StudyACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation.
The ACCM/PALS guidelines address early correction of paediatric septic shock using conventional measures. In the evolution of these recommendations, indirect measures of the balance between systemic oxygen delivery and demands using central venous or superior vena cava oxygen saturation (ScvO(2) > or = 70%) in a goal-directed approach have been added. However, while these additional goal-directed endpoints are based on evidence-based adult studies, the extrapolation to the paediatric patient remains unvalidated. ⋯ This study supports the current ACCM/PALS guidelines. Goal-directed therapy using the endpoint of a ScvO(2)> or =70% has a significant and additive impact on the outcome of children and adolescents with septic shock.
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Intensive care medicine · Jun 2008
HMGB1 as a predictor of organ dysfunction and outcome in patients with severe sepsis.
To study the predictive value of high mobility group box-1 protein (HMGB1) and hospital mortality in adult patients with severe sepsis. ⋯ Serum HMGB1 concentrations were elevated in patients with severe sepsis, but did not differ between survivors and non-survivors and did not predict hospital mortality.
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Intensive care medicine · Jun 2008
Comparative StudyA double-layer tracheal tube cuff designed to prevent leakage: a bench-top study.
We designed a new endotracheal tube (ETT) cuff that does not form the folds that cause leakage of colonized subglottic secretions upon inflation within the trachea: a standard high-volume low-pressure cuff was draped with a second, highly elastic cuff made of a low-protein guayule natural latex rubber with 0.5 ml gel between the cuffs. We compared this prototype ETT cuff with four commercially available ETTs for efficacy in the prevention of fluid leakage across the cuff. ⋯ Our prototype ETT cuff significantly reduced fluid leakage in this bench-top study. In vivo testing and evaluation is to follow.