Intensive care medicine
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Intensive care medicine · May 2009
Biography Historical ArticlePost-traumatic growth in parents after a child's admission to intensive care: maybe Nietzsche was right?
The aim of this prospective study was to establish the degree to which parents report post-traumatic growth after the intensive care treatment of their child. ⋯ Post-traumatic growth emerged as a salient concept for this population. It was more strongly associated with moderate levels of post-traumatic stress, than high or low levels.
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Intensive care medicine · May 2009
Is C-reactive protein a good prognostic marker in septic patients?
Several studies have shown that C-reactive protein (CRP) is a marker of infection. The aim of this study was to evaluate CRP as marker of prognosis outcome in septic patients and to assess the correlation of CRP with severity of sepsis. ⋯ In septic patients, CRP of the day of sepsis diagnosis is not a good marker of prognosis.
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Intensive care medicine · May 2009
Intraoperative validation of a new system for invasive continuous cardiac output measurement.
Although bolus thermodilution technique for cardiac output (CO) measurement has widespread acceptance, new systems are currently available. We evaluated a continuous CO system (TruCCOMS, Aortech International Inc.) that operates on the thermal conservation principle and we compared it with the reference standard transit time flow measurement (TTFM). ⋯ Although TruCCOMS may significantly underestimate CO, measurement trends correlate with TTFM. For this reason, a negative trend in RV output should trigger more specific diagnostic procedures.
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Intensive care medicine · May 2009
Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to initiation of antimicrobial therapy.
To describe the incidence and outcomes associated with early acute kidney injury (AKI) in septic shock and explore the association between duration from hypotension onset to effective antimicrobial therapy and AKI. ⋯ Early AKI is common in septic shock. Delays to appropriate antimicrobial therapy may contribute to significant increases in the incidence of AKI. Survival was considerably lower for septic shock associated with early AKI, with increasing severity of AKI, and with increasing delays to appropriate antimicrobial therapy.
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Intensive care medicine · May 2009
Impact of restriction of third generation cephalosporins on the burden of third generation cephalosporin resistant K. pneumoniae and E. coli in an ICU.
To test whether a reduction of third generation cephalosporin (3GC) use has a sustainable positive impact on the high endemic prevalence of 3GC resistant K. pneumoniae and E. coli. ⋯ Reducing 3GCs does not necessarily impact positively on the resistance situation in the ICU setting. Likewise, replacing piperacillin with beta-lactamase inhibitor might provide a selection pressure on 3GC resistant E. coli and K. pneumoniae. To improve resistance, it might not be sufficient to restrict interventions to a risk area.