Intensive care medicine
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Intensive care medicine · Jul 2018
Observational StudyEffects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study.
Chlorhexidine oral care is widely used in critically and non-critically ill hospitalized patients to maintain oral health. We investigated the effect of chlorhexidine oral care on mortality in a general hospitalized population. ⋯ These data argue against the indiscriminate widespread use of chlorhexidine oral care in hospitalized patients, in the absence of proven benefit in specific populations.
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Intensive care medicine · Jul 2018
Review Meta Analysis Comparative StudyLow-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis.
To assess the effect of low dose corticosteroids on outcomes in adults with septic shock. ⋯ In adults with septic shock treated with low dose corticosteroids, short- and longer-term mortality are unaffected, adverse events increase, but duration of shock, mechanical ventilation and ICU stay are reduced. PROSPERO registration no. CRD42017084037.
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Intensive care medicine · Jul 2018
Multicenter Study Observational StudyAcceleration of the learning curve for mastering basic critical care echocardiography using computerized simulation.
To assess the impact of computerized transthoracic echocardiography (TTE) simulation on the learning curve to achieve competency in basic critical care echocardiography (CCE). ⋯ Adjunctive computerized simulation accelerates the learning curve of basic CCE in improving practical and technical skills and reduces the number of TTE examinations required to reach competency.
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Intensive care medicine · Jul 2018
Multicenter Study Observational StudyCirculating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study.
Sepsis and non-septic systemic inflammatory response syndrome (SIRS) are the same syndromes, differing by their cause, sepsis being secondary to microbial infection. Microbiological tests are not enough to detect infection early. While more than 50 biomarkers have been proposed to detect infection, none have been repeatedly validated. ⋯ The circulating biomarkers tested were found to discriminate poorly between sepsis and non-septic SIRS, and no combination performed better than CRP alone.
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Intensive care medicine · Jul 2018
Multicenter StudyIncreased risk of death and readmission after hospital discharge of critically ill patients in a developing country: a retrospective multicenter cohort study.
To describe long-term mortality and hospital readmissions of patients admitted to Brazilian intensive care units (ICU). ⋯ In a public healthcare system of a developing country, ICU patients have excessive long-term mortality and frequent readmissions. The ICU burden tended to reduce over time after hospital discharge.