Journal of critical care
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Journal of critical care · Sep 2009
Prognostic value of indocyanine green elimination assessed with LiMON in septic patients.
Sepsis is the most frequent infection with high mortality rates in intensive care units (ICUs), and the prediction of outcome is important in the decision-making process. ⋯ The results suggest that ICG-PDR, assessed with a user-friendly noninvasive bedside LiMON device, is a good predictor of survival in septic patients. Sensitivity and specificity of the noninvasive measurement of ICG-PDR on ICU admission was comparable to that obtained by APACHE II scores.
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Journal of critical care · Sep 2009
ReviewSurvival benefit of the full selective digestive decontamination regimen.
We assessed the impact of the full protocol of selective decontamination of the digestive tract (SDD) using parenteral and enteral antimicrobials on mortality. ⋯ The findings strongly indicated that the full protocol of SDD reduces mortality in critically ill patients, in particular when successful decontamination is obtained. Eighteen patients should be treated with SDD to prevent one death.
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Journal of critical care · Sep 2009
Randomized Controlled Trial Multicenter StudyA randomized controlled trial comparing a computer-assisted insulin infusion protocol with a strict and a conventional protocol for glucose control in critically ill patients.
The objective of this study is to evaluate blood glucose (BG) control efficacy and safety of 3 insulin protocols in medical intensive care unit (MICU) patients. ⋯ The CAIP is safer than and as effective as the standard strict protocol for controlling glucose in MICU patients. Hypoglycemia was rare under conventional treatment. However, BG levels were higher than with IV insulin protocols.
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Journal of critical care · Sep 2009
Meta AnalysisThe efficacy and dosage effect of corticosteroids for the prevention of atrial fibrillation after cardiac surgery: a systematic review.
Atrial fibrillation (AF) complicates up to 60% of patients after cardiac surgery. Current prophylactic measures are inadequate. Corticosteroids down-regulate activation of the proinflammatory response (including C-reactive protein) after cardiopulmonary bypass and have been suggested to reduce the risk of postoperative AF. ⋯ Moderate-dosage corticosteroid (hydrocortisone) should be considered for the prevention of AF in high-risk patients undergoing cardiac surgery. Although the optimal dose, dosing interval, and duration of therapy is unclear, a single dose given at induction may be adequate. The interaction between corticosteroids, beta-blockers, and amiodarone requires further study.