Intensive care medicine
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Intensive care medicine · Feb 2014
Multicenter StudyPatients with faecal peritonitis admitted to European intensive care units: an epidemiological survey of the GenOSept cohort.
Faecal peritonitis (FP) is a common cause of sepsis and admission to the intensive care unit (ICU). The Genetics of Sepsis and Septic Shock in Europe (GenOSept) project is investigating the influence of genetic variation on the host response and outcomes in a large cohort of patients with sepsis admitted to ICUs across Europe. Here we report an epidemiological survey of the subset of patients with FP. ⋯ In this large cohort of patients admitted to European ICUs with FP the 6 month mortality was 31.6%. The most consistent predictors of mortality across all time points were increased age, development of acute renal dysfunction during the first week of admission, lower haematocrit and hypothermia on day 1 of ICU admission.
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Innate-like lymphocytes are a recently described subset of the immune response with known antibacterial properties. This human trial in critically ill patients provides the first evidence of the drop in MAIT cells during bacterial sepsis, which compounds the already known immune defects. The persistent depletion and potential for nosocomial infections is an interesting finding and one likely to provide fertile grounds for future studies.
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Intensive care medicine · Feb 2014
Review Practice GuidelinePalliative care in the ICU: relief of pain, dyspnea, and thirst-A report from the IPAL-ICU Advisory Board.
Pain, dyspnea, and thirst are three of the most prevalent, intense, and distressing symptoms of intensive care unit (ICU) patients. In this report, the interdisciplinary Advisory Board of the Improving Palliative Care in the ICU (IPAL-ICU) Project brings together expertise in both critical care and palliative care along with current information to address challenges in assessment and management. ⋯ Relief of symptom distress is a key component of critical care for all ICU patients, regardless of condition or prognosis. Evidence-based approaches for assessment and treatment together with well-designed work systems can help ensure comfort and related favorable outcomes for the critically ill.