Intensive care medicine
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Intensive care medicine · Apr 2013
Immature platelet fraction in predicting sepsis in critically ill patients.
To establish whether in critically ill patients without sepsis at intensive care unit (ICU) admission the percentage immature platelet fraction (IPF%) is a cellular marker predicting sepsis to verify a possible correlation between IPF% changes and manifest sepsis and describe the IPF% time course after ICU admission. ⋯ In patients without sepsis at ICU admission IPF% increases before sepsis becomes manifest. Measuring IPF% through an easily available technology can therefore provide an early cellular marker predicting the development of sepsis.
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Intensive care medicine · Apr 2013
Bench comparative evaluation of a new generation and standard helmet for delivering non-invasive ventilation.
To evaluate the performance of a new helmet (NH) recently introduced into clinical use relative to that of the standard helmet (SH) in terms of delivering non-invasive continuous positive airway pressure (nCPAP) and pressure support ventilation (nPSV). ⋯ Compared to the SH, the NH is equally effective in delivering nCPAP and more effective in delivering nPSV, and it is used to avoid the need for armpit braces.
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Intensive care medicine · Apr 2013
Clinical outcomes of Pseudomonas aeruginosa pneumonia in intensive care unit patients.
Our aim was to identify the clinical profile of intensive care unit (ICU) patients with Pseudomonas aeruginosa (PA) pneumonia and the impact on ICU mortality and duration of mechanical ventilation (MV) of multidrug resistance (MDR) in the PA isolate and inadequate initial antibiotic therapy (IIAT). ⋯ Our findings highlight the importance of IIAT as a risk factor for mortality in ICU patients with PA pneumonia. MDR in the PA isolate, like IIAT, can significantly increase the need for MV.
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Intensive care medicine · Apr 2013
Stroke volume determination using transcardiopulmonary thermodilution and arterial pulse contour analysis in severe aortic valve disease.
Transcardiopulmonary thermodilution (TPTD, SVTD) as well as calibrated (SVPC CAL) and uncalibrated (SVPC UNCAL) arterial pulse contour analysis (PC) are increasingly promoted as less-invasive technologies to measure stroke volume (SV) but their reliability in aortic valve disease was unknown. The objective of this prospective study was to investigate the validity of three less-invasive techniques to assess SV in conditions involving aortic stenosis (AS) and valvuloplasty-induced aortic insufficiency (AI) compared with transesophageal echocardiography. ⋯ Transcardiopulmonary thermodilution is valid in aortic valve dysfunction. Calibration of PC substantially improves reliability in aortic valve disease. Calibrated PC is valid in severe AS. Valvuloplasty-induced AI seriously confounds PC measurements. In uncalibrated PC approaches, the relative SV trend is superior to single absolute values.