Intensive care medicine
-
Intensive care medicine · Apr 2016
Multicenter Study Observational StudyPre-morbid glycemic control modifies the interaction between acute hypoglycemia and mortality.
To study the impact of pre-morbid glycemic control on the association between acute hypoglycemia in intensive care unit (ICU) patients and subsequent hospital mortality in critically ill patients. ⋯ In critically ill patients, chronic pre-morbid hyperglycemia increases the risk of hypoglycemia and modifies the association between acute hypoglycemia and mortality.
-
Intensive care medicine · Apr 2016
Review Meta AnalysisIncidence and associations of acute kidney injury after major abdominal surgery.
Acute kidney injury (AKI) is a recognised risk factor for adverse outcomes in critical illness and hospitalised patients in general. To understand the incidence and associations of AKI as a peri-operative complication of major abdominal surgery, we conducted a systematic literature review and meta-analysis. ⋯ Using modern consensus definitions, AKI is a common complication of major abdominal surgery that is associated with adverse patient outcomes including death. While a causative role for AKI cannot be concluded from this analysis, as an important signal of peri-operative harm, AKI should be regarded as an important surgical outcome measure and potential target for clinical interventions.
-
Intensive care medicine · Apr 2016
Randomized Controlled Trial Multicenter Study Comparative StudyHigher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial.
In shock, hypotension may contribute to inadequate oxygen delivery, organ failure and death. We conducted the Optimal Vasopressor Titration (OVATION) pilot trial to inform the design of a larger trial examining the effect of lower versus higher mean arterial pressure (MAP) targets for vasopressor therapy in shock. ⋯ This pilot study supports the feasibility of a large trial comparing lower versus higher MAP targets for shock. Further research may help delineate the reasons for vasopressor dosing in excess of prescribed targets and how individual patient characteristics modify the response to vasopressor therapy.