Intensive care medicine
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Intensive care medicine · Dec 2015
Predictive value for weakness and 1-year mortality of screening electrophysiology tests in the ICU.
Muscle weakness in long-stay ICU patients contributes to 1-year mortality. Whether electrophysiological screening is an alternative diagnostic tool in unconscious/uncooperative patients remains unknown. We aimed to determine the diagnostic properties of abnormal compound muscle action potential (CMAP), sensory nerve action potential (SNAP), and spontaneous electrical activity (SEA) for Medical Research Council (MRC)-defined weakness and their predictive value for 1-year mortality. ⋯ The diagnostic properties of electrophysiological screening vary over time. Abnormal CMAP documented early during critical illness carries information about longer-term outcome, which should be further investigated mechanistically.
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Intensive care medicine · Dec 2015
Predicting fluid responsiveness in 100 critically ill children: the effect of baseline contractility.
Fluid overload is a risk factor for poor outcome in intensive care; thus volume loading should be tailored towards patients who are likely to increase stroke volume. We aimed to evaluate the paediatric predictive ability (stroke volume increase of at least 15 % after fluid bolus) of novel and established volumetric and dynamic haemodynamic variables, and assess the influence of baseline contractility on response. ⋯ Current paediatric predictors of volume response perform poorly; prediction may be improved if baseline contractility is taken into account.
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Intensive care medicine · Dec 2015
Very high volume hemofiltration with the Cascade system in septic shock patients.
We compared hemodynamic and biological effects of the Cascade system, which uses very high volume hemofiltration (HVHF) (120 mL kg(-1) h(-1)), with those of usual care in patients with septic shock. ⋯ Very HVHF using the Cascade system can safely be used in patients presenting with septic shock, but it was not associated with a reduction in the need for catecholamines during the first 28 days.