Intensive care medicine
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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.
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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.
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Intensive care medicine · Apr 2016
Multicenter StudyRapid response team and hospital mortality in hospitalized patients.
Although rapid response systems are known to reduce in-hospital cardiac arrest rate, their effect on mortality remains debated. The present study aimed to evaluate the effect of implementing an intensivist-led rapid response team (RRT) on mortality in hospitalized patients. ⋯ In the present retrospective study, implementation of an intensivist-led RRT along with educational modules, publicity and bedside simulation-based training was associated with a significant decrease in unexpected and overall mortality of inpatients.