Intensive care medicine
-
Intensive care medicine · Dec 2016
Review Meta AnalysisExtracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis.
Veno-arterial extracorporeal life support (ECLS) is increasingly used in patients during cardiac arrest and cardiogenic shock, to support both cardiac and pulmonary function. We performed a systematic review and meta-analysis of cohort studies comparing mortality in patients treated with and without ECLS support in the setting of refractory cardiac arrest and cardiogenic shock complicating acute myocardial infarction. ⋯ In cardiac arrest, the use of ECLS was associated with an increased survival rate as well as an increase in favourable neurological outcome. In the setting of cardiogenic shock there was an increased survival with ECLS compared with IABP.
-
Intensive care medicine · Dec 2016
Multicenter Study Observational StudyRefractory septic shock in children: a European Society of Paediatric and Neonatal Intensive Care definition.
Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal intensive care (ESPNIC) experts' definition of paediatric RSS. ⋯ This ESPNIC definition of RSS accurately identifies children with the most severe form of septic shock.
-
Intensive care medicine · Dec 2016
Randomized Controlled Trial Multicenter StudyPlasma cytokine levels predict response to corticosteroids in septic shock.
To investigate if plasma cytokine concentrations predict a beneficial response to corticosteroid treatment in septic shock patients. ⋯ Plasma concentration of selected cytokines is a potential predictive biomarker to identify septic shock patients that may benefit from treatment with corticosteroids.
-
Intensive care medicine · Dec 2016
Multicenter Study Observational StudyPotentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study.
To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality. ⋯ Higher PEEP, lower peak, plateau, and driving pressures, and lower respiratory rate are associated with improved survival from ARDS.