Intensive care medicine
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Intensive care medicine · Jun 2007
Serum lactate as a predictor of mortality in patients with infection.
To determine the utility of an initial serum lactate measurement for identifying high risk of death in patients with infection. ⋯ When broadly implemented in routine practice, measurement of lactate in patients with infection and possible sepsis can affect assessment of mortality risk. Specifically, an initial lactate >or=4.0 mmol/l substantially increases the probability of acute-phase death.
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Intensive care medicine · Jun 2007
Pediatric delirium in critical illness: phenomenology, clinical correlates and treatment response in 40 cases in the pediatric intensive care unit.
To study the phenomenology, clinical correlates, and response to treatment of delirium in critically ill children in the pediatric intensive care unit (PICU). ⋯ The rate of delirium in critically ill children on a PICU is not negligible, yet prospective studies of the phenomenology, risk factors and treatment of childhood delirium are very rare. Once pediatric delirium has been recognized, it generally responds well to treatment.
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Intensive care medicine · Jun 2007
Plethysmographic dynamic indices predict fluid responsiveness in septic ventilated patients.
In septic patients, reliable non-invasive predictors of fluid responsiveness are needed. We hypothesised that the respiratory changes in the amplitude of the plethysmographic pulse wave (DeltaP(PLET)) would allow the prediction of changes in cardiac index following volume administration in mechanically ventilated septic patients. ⋯ The present study found DeltaP(PLET) to be as accurate as DeltaPP for predicting fluid responsiveness in mechanically ventilated septic patients.
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Intensive care medicine · Jun 2007
Subsyndromal delirium in the ICU: evidence for a disease spectrum.
ICU delirium is common and adverse. The Intensive Care Delirium Screening Checklist (ICDSC) score ranges from 0 to 8, with a score of 4 or higher indicating clinical delirium. We investigated whether lower (subsyndromal) values affect outcome. ⋯ Clinical delirium is common, important and adverse in the critically ill. A graded diagnostic scale permits detection of a category of subsyndromal delirium which occurs in many ICU patients, and which is associated with adverse outcome.
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Intensive care medicine · Jun 2007
Lipopolysaccharide-binding protein, lipopolysaccharide, and soluble CD14 in sepsis of critically ill neonates and children.
To compare the diagnostic accuracy of lipopolysaccharide-binding protein (LBP) for sepsis in critically ill neonates and children with the two markers participating in the same inflammatory pathway, lipopolysaccharide and soluble CD14. ⋯ In critically ill neonates and children LBP concentration on the first day of suspected sepsis is a better marker of sepsis than lipopolysaccharide, soluble CD14, procalcitonin, and in neonates younger than 48 h and children, also a better marker than C-reactive protein. Lipopolysaccharide and soluble CD14 are not suitable markers for the differentiation of infectious and noninfectious SIRS.