Intensive care medicine
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To quantify sepsis-induced alterations in changes in muscle tissue oxygenation (StO(2)) after an ischemic challenge using near-infrared spectroscopy (NIRS), and to test the hypothesis that these alterations are related to outcome. ⋯ Altered recovery in StO(2) after an ischemic challenge is frequent in septic patients and more pronounced in the presence of shock. The presence and persistence of these alterations in the first 24[Symbol: see text]h of sepsis are associated with worse outcome.
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Intensive care medicine · Sep 2007
Prolonged use of carbapenems and colistin predisposes to ventilator-associated pneumonia by pandrug-resistant Pseudomonas aeruginosa.
We present our experience with five cases of pandrug-resistant Pseudomonas aeruginosa ventilator-associated pneumonia (VAP) and analysis of risk factors. ⋯ Prolonged carbapenem-colistin use predisposes to VAP by pandrug-resistant P. aeruginosa. Cross-transmission may be facilitated by open suctioning.
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To describe the serum cortisol profile and evaluate the adrenal response in children with septic shock, and determine the influence of these factors on the outcome and mortality in this group. ⋯ Adrenal insufficiency is a frequent finding in children with septic shock. The low-dose corticotrophin stimulation test seems to be an important tool to distinguish between a normal cortisol response to stress and evidence of adrenal failure. Mortality was significantly higher in children that failed to respond to a corticotrophin stimulation test.
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Intensive care medicine · Sep 2007
Association of cell-free plasma DNA with hospital mortality and organ dysfunction in intensive care unit patients.
To investigate the concentration of cell-free plasma DNA and its association with organ dysfunction and hospital mortality in intensive care unit patients. ⋯ The maximum plasma DNA concentration measured during the first 96[Symbol: see text]h of intensive care is associated with the degree of organ dysfunction and disease severity. Moreover, the maximum DNA concentration is independently associated with hospital mortality.
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Intensive care medicine · Sep 2007
Pharmacodynamics and organ storage of hydroxyethyl starch in acute hemodilution in pigs: influence of molecular weight and degree of substitution.
To determine the differential influence of molecular weight and the degree of substitution of HES solutions on pharmacodynamics and pharmacokinetics including organ storage in a model of acute hemodilution in pigs. ⋯ All preparations analyzed sufficiently restored macro- and microcirculation; however, for all solutions relevant tissue storage of HES was observed after only 6 h.