Intensive care medicine
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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.
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Intensive care medicine · Apr 2012
Multicenter Study Comparative StudyDevelopment of demographics and outcome of very old critically ill patients admitted to intensive care units.
To evaluate the development of demographics and outcome of very old (>80 years) critically ill patients admitted to intensive care units. ⋯ The relative and absolute numbers of very old patients increased over the study period, as did the severity of illness. Despite this, risk-adjusted hospital mortality improved over the study period. Females dominated in the very old patients and exhibited moreover a better outcome compared with males.
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Intensive care medicine · Apr 2012
Accuracy of non-invasive blood pressure monitoring in very preterm infants.
Blood pressure (BP) monitoring is an essential procedure in intensive care. There is controversy about the reliability of non-invasive BP measurements in very preterm infants. This prospective trial compared non-invasive BP monitoring with BP monitoring via an umbilical arterial catheter (UAC) in this population. ⋯ Although the average differences between invasive and non-invasive BP measurements are acceptable, the range of under- and overestimation of non-invasive BP measurements is large and not consistent, making reliance on non-invasive modalities to guide circulatory management problematic. If arterial BP monitoring is not available, our results suggest measuring non-invasive BP on the leg in preterm infants with a birth weight no greater than 1,000 g.