Intensive care medicine
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Intensive care medicine · Apr 2012
Randomized Controlled TrialDyslipidemia: a prospective controlled randomized trial of intensive glycemic control in sepsis.
Metabolic disturbances are quite common in critically ill patients. Glycemic control appears to be an important adjuvant therapy in such patients. In addition, disorders of lipid metabolism are associated with worse prognoses. The purpose of this study was to investigate the effects that two different glycemic control protocols have on lipid profile and metabolism. ⋯ Free fatty acids respond to intensive glycemic control and, because of their high toxicity, can be a therapeutic target in patients with sepsis.
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Intensive care medicine · Apr 2012
Randomized Controlled TrialStandard subcutaneous dosing of unfractionated heparin for venous thromboembolism prophylaxis in surgical ICU patients leads to subtherapeutic factor Xa inhibition.
To assess coagulation status and factor Xa inhibition in surgical intensive care unit (ICU) patients administered prophylactic unfractionated heparin for venous thromboembolism (VTE) prophylaxis. ⋯ Standard of care subcutaneous dosing of unfractionated heparin for VTE prophylaxis in surgical ICU patients leads to subtherapeutic levels of factor Xa inhibition.
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Intensive care medicine · Apr 2012
In vivo conditioning of acid-base equilibrium by crystalloid solutions: an experimental study on pigs.
Large infusion of crystalloids may induce acid-base alterations according to their strong ion difference ([SID]). We wanted to prove in vivo, at constant PCO(2), that if the [SID] of the infused crystalloid is equal to baseline plasma bicarbonate, the arterial pH remains unchanged, if lower it decreases, and if higher it increases. ⋯ Results support the hypothesis that at constant PCO(2), pH changes are predictable from the difference between the [SID] of the infused solution and baseline plasma bicarbonate concentration.
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Intensive care medicine · Apr 2012
Randomized Controlled Trial Multicenter StudySleep and other factors associated with mental health and psychological distress after intensive care for critical illness.
Some patients who survive intensive care unit (ICU) treatment report psychological sequelae during recovery. This study examined factors associated with psychological outcomes of former ICU patients up to 6 months after hospital discharge. ⋯ Female gender, early levels of increased stress and problems sleeping are associated with worse psychological recovery for survivors of critical illness.
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Intensive care medicine · Apr 2012
ReviewRecommendations for sepsis management in resource-limited settings.
To provide clinicians practicing in resource-limited settings with a framework to improve the diagnosis and treatment of pediatric and adult patients with sepsis. ⋯ Only scarce evidence exists for the management of pediatric and adult sepsis in resource-limited settings. The presented recommendations may help to improve sepsis management in middle- and low-income countries.