Intensive care medicine
-
Intensive care medicine · Mar 2011
Randomized Controlled Trial Multicenter Study Comparative StudyA prospective, randomized, double-blind, multicenter study comparing remifentanil with fentanyl in mechanically ventilated patients.
To compare the quality of analgesia provided by a remifentanil-based analgesia regime with that provided by a fentanyl-based regime in critically ill patients. ⋯ The use of remifentanil-based analgesia in critically ill patients was not superior regarding the achievement and maintenance of sufficient analgesia compared with fentanyl-based analgesia.
-
Intensive care medicine · Mar 2011
Randomized Controlled Trial Multicenter StudyImmunoparalysis and nosocomial infection in children with multiple organ dysfunction syndrome.
Immunoparalysis defined by prolonged monocyte human leukocyte antigen DR depression is associated with adverse outcomes in adult severe sepsis and can be reversed with granulocyte macrophage colony-stimulating factor (GM-CSF). We hypothesized that immunoparalysis defined by whole-blood ex vivo lipopolysaccharide-induced tumor necrosis factor-alpha (TNFα) response <200 pg/mL beyond day 3 of multiple organ dysfunction syndrome (MODS) is similarly associated with nosocomial infection in children and can be reversed with GM-CSF. ⋯ Similar to in adults, immunoparalysis is a potentially reversible risk factor for development of nosocomial infection in pediatric MODS. Whole-blood ex vivo TNFα response is a promising biomarker for monitoring this condition.
-
Intensive care medicine · Mar 2011
Multicenter Study Comparative StudyCost-effectiveness of the Surviving Sepsis Campaign protocol for severe sepsis: a prospective nation-wide study in Spain.
Severe sepsis is associated with high mortality and increased costs. The 'Surviving Sepsis Campaign' (SSC) protocol was developed as an international initiative to reduce mortality. However, its cost-effectiveness is unknown. ⋯ The SSC protocol seems to be a cost-effective option for treating severe sepsis in Spain.
-
Intensive care medicine · Mar 2011
Randomized Controlled Trial Multicenter StudyIntravenous sildenafil for postoperative pulmonary hypertension in children with congenital heart disease.
To evaluate the efficacy and safety of intravenous sildenafil for immediate postoperative pulmonary hypertension (PH) in pediatric patients undergoing congenital heart surgery. ⋯ Intravenous sildenafil reduced pulmonary artery pressure and shortened time to extubation and intensive care unit stay in children with postoperative PH.
-
Intensive care medicine · Mar 2011
Multicenter StudySerum and urine cystatin C are poor biomarkers for acute kidney injury and renal replacement therapy.
To evaluate whether cystatin C in serum (sCyC) and urine (uCyC) can predict early acute kidney injury (AKI) in a mixed heterogeneous intensive care unit (ICU), and also whether these biomarkers can predict the need for renal replacement therapy (RRT). ⋯ In this study, sCyC and uCyC were poor biomarkers for prediction of AKI and the need for RRT.