Intensive care medicine
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Intensive care medicine · Dec 2016
Randomized Controlled Trial Multicenter StudyEffect of early postextubation high-flow nasal cannula vs conventional oxygen therapy on hypoxaemia in patients after major abdominal surgery: a French multicentre randomised controlled trial (OPERA).
High-flow nasal cannula (HFNC) oxygen therapy is attracting increasing interest in acute medicine as an alternative to standard oxygen therapy; however, its use to prevent hypoxaemia after major abdominal surgery has not been evaluated. Our trial was designed to close this evidence gap. ⋯ Among patients undergoing major abdominal surgery, early preventive application of high-flow nasal cannula oxygen therapy after extubation did not result in improved pulmonary outcomes compared with standard oxygen therapy.
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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.
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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
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.
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Intensive care medicine · Dec 2016
Multicenter Study Observational StudyIncidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study.
To estimate the incidence density, point prevalence and outcome of severe sepsis and septic shock in German intensive care units (ICUs). ⋯ Severe sepsis and septic shock continue to be a frequent syndrome associated with high hospital mortality. Nosocomial infections play a major role in the development of sepsis. This study presents a pragmatic, affordable and feasible method for the surveillance of sepsis epidemiology. Implementation of the new SEPSIS-3 definitions may have a major effect on future epidemiological data.