Intensive care medicine
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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.
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Intensive care medicine · Dec 2016
Review Meta AnalysisPassive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis.
We performed a systematic review and meta-analysis of studies investigating the passive leg raising (PLR)-induced changes in cardiac output (CO) and in arterial pulse pressure (PP) as predictors of fluid responsiveness in adults. ⋯ PLR-induced changes in CO very reliably predict the response of CO to volume expansion in adults with acute circulatory failure. When PLR effects are assessed by changes in PP, the specificity of the PLR test remains acceptable but its sensitivity is poor.
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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.
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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.