Intensive care medicine
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Intensive care medicine · Aug 2006
Adrenal axis function does not appear to be associated with hemodynamic improvement in septic shock patients systematically receiving glucocorticoid therapy.
There is mounting evidence showing the value of low-dose corticosteroids in patients with septic shock requiring vasopressor therapy. It remains unclear whether adrenal function tests should be carried out systematically to guide the decision on glucocorticoid therapy. ⋯ In catecholamine-dependent septic shock patients managed with systematic glucocorticoid therapy the results of ACTH stimulation do not predict hemodynamic improvement.
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Intensive care medicine · Aug 2006
Postoperative phrenic nerve palsy: early clinical implications and management.
We examined the clinical impact of diaphragmatic palsy (DP) as a result of phrenic nerve injury following cardiothoracic surgery, specifically its effects on morbidity and mortality, early regeneration capacity of the phrenic nerve, and role of surgical diaphragmatic plication. ⋯ Especially in newborns and young infants with DP the length of mechanical ventilation, ICU stay, and hospital stay are prolonged. Early spontaneous recovery of the phrenic nerve is rare. In cases of respiratory impairment early transthoracic diaphragmatic plication is an effective means of treatment.
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Intensive care medicine · Aug 2006
The prevalence and characteristics of anaemia at discharge home after intensive care.
To document the prevalence of anaemia among ICU survivors at the time of discharge home and to document red cell morphology among anaemic patients. ⋯ Anaemia is highly prevalent among survivors of critical illness and persists until hospital discharge. Most patients have red cell morphology similar to "anaemia of chronic disease".