Intensive care medicine
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Preeclampsia remains an important cause of avoidable maternal morbidity and mortality. Publication of guidelines and monitoring adherence to life-saving therapies should be prioritized. Prediction of fluid responsiveness requires individual hemodynamic investigation. Future studies are required to determine the optimal early warning system and monitoring tools for providing early and non-invasive hemodynamic assessment.
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Intensive care medicine · Jul 2015
Prognostication of post-cardiac arrest coma: early clinical and electroencephalographic predictors of outcome.
To determine the temporal evolution, clinical correlates, and prognostic significance of electroencephalographic (EEG) patterns in post-cardiac arrest comatose patients treated with hypothermia. ⋯ Suppression-burst or a low voltage at 24 h after ROSC was not compatible with good outcome in this series. Normal background voltage without epileptiform discharges predicted a good outcome.
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Intensive care medicine · Jul 2015
Practice GuidelineStrategies to reduce curative antibiotic therapy in intensive care units (adult and paediatric).
Emerging resistance to antibiotics shows no signs of decline. At the same time, few new antibacterials are being discovered. There is a worldwide recognition regarding the danger of this situation. ⋯ Five fields were explored: i) the link between the resistance of bacteria and the use of antibiotics in intensive care; ii) which microbiological data and how to use them to reduce antibiotic consumption; iii) how should antibiotic therapy be chosen to limit consumption of antibiotics; iv) how can antibiotic administration be optimized; v) review and duration of antibiotic treatments. In each institution, the appropriation of these recommendations should arouse multidisciplinary discussions resulting in better knowledge of local epidemiology, rate of antibiotic use, and finally protocols for improving the stewardship of antibiotics. These efforts should contribute to limit the emergence of resistant bacteria.