Intensive care medicine
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Intensive care medicine · Sep 2010
ReviewAcute kidney injury in elderly intensive care patients: a review.
The elderly are at high risk for acute kidney injury (AKI). With the aging of the population, the demand for intensive care unit (ICU) admission from older patients will continue to rise, and this clinical entity will likely become increasingly common. ⋯ We also consider the difficulties in achieving an early diagnosis in the elderly ICU patient, the particularities related to AKI treatment in this age group, and the data available on differences in renal recovery and mortality between the young and the old with renal injury. More importantly, we highlight the methods for prevention of AKI development or worsening in the elderly critically ill patient.
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Intensive care medicine · Sep 2010
Randomized Controlled TrialProbiotics in the critically ill patient: a double blind, randomized, placebo-controlled trial.
Probiotics have been shown to be able to restore a non-pathogenic digestive flora, to prevent digestive colonization by pathogenic bacteria, and to modulate immunity. The aim of this study was to assess the effects of prophylactic probiotic administration in patients ventilated for up to 2 days. ⋯ Although numerous uncertainties remain (type and the number of strains to use, delay and length of administration), and despite an acceptable safety profile, the daily prophylactic administration of probiotics cannot be encouraged in the critically ill patient.
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Intensive care medicine · Sep 2010
Comparative StudyDetecting traumatic internal carotid artery dissection using transcranial Doppler in head-injured patients.
The early diagnosis of traumatic internal carotid artery dissection (TICAD) is essential for initiating appropriate treatment and improving outcome. We searched for criteria from transcranial Doppler (TCD) measurements on admission that could be associated with subsequent TICAD diagnosis in patients with traumatic brain injury (TBI). ⋯ Our results suggest that significant asymmetry in the systolic blood flow velocity between the MCAs and a reduced ipsilateral pulsatility index could be criteria from TCD measurements associated with the occurrence of TICAD in head-injured patients. If prospectively validated, these findings could be incorporated in screening protocols for TICAD in patients with TBI.
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Intensive care medicine · Sep 2010
Comparative StudyImpact of simulation-based learning on medication error rates in critically ill patients.
To compare medication administration error rates before and after the provision of educational sessions using either traditional didactic lecture or simulation-based training. ⋯ Simulation-based learning provides a significant advantage to patient care through the reduction of medication administration errors compared to lecture style education.
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Intensive care medicine · Sep 2010
APACHE-II score and Killip class for patients with acute myocardial infarction.
To analyse the influence on the prognosis of intensive care unit (ICU) patients with acute myocardial infarction (AMI): prognostic index score, Killip class, AMI site, thrombolysis and other variables that might improve prognostic capacity and functioning of the APACHE-II index. ⋯ APACHE-II score and Killip class are useful for assessing the severity of patients with AMI and are complementary. Each can be used with a few commonly gathered clinical variables to construct prognostic models to assess severity. Their joint application yields a model with excellent discrimination capacity.