Critical care medicine
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Critical care medicine · May 2013
Review Comparative StudyDeterminants of mortality after hospital discharge in ICU patients: literature review and Dutch cohort study.
First, to conduct a literature review on the long-term mortality of ICU patients and its determinants. Second, to assess the influence of the found determinants at 3, 6, and 12 months mortality after hospital discharge in the Dutch ICU population. ⋯ The long-term mortality found in the included articles was difficult to compare due to low quality, variation in case-mix, study design, and differences in case-mix adjustment. The most commonly used determinants in the literature were comparable to the most important determinants found in the Dutch cohort study.
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Critical care medicine · May 2013
Randomized Controlled Trial Comparative StudyContinuous administration of enteral lipid- and protein-rich nutrition limits inflammation in a human endotoxemia model.
An overzealous inflammatory response is an important cause of morbidity and mortality in surgical, trauma, and critically ill patients. Enteral administration of lipid-rich nutrition was previously shown to attenuate inflammation and reduce organ damage via a cholecystokinin-1 receptor-mediated vagovagal reflex in animal studies. The current preclinical study investigates the immunomodulatory potential of a custom-made enteral nutrition during systemic inflammation in man. ⋯ The current preclinical study expands the immunomodulating effects of enteral nutrition as previously observed in rodents to man. Continuous administration of enteral nutrition resulted in a rapid anti-inflammatory effect. Furthermore, enrichment of the nutritional composition with lipid and protein was shown to enhance the anti-inflammatory potential. Therefore, continuous enteral administration of lipid- and protein-rich nutrition is a promising intervention to modulate the immune response in the early course of systemic inflammation in man.
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Critical care medicine · May 2013
Comparative StudyExtracorporeal cardiopulmonary resuscitation for patients with out-of-hospital cardiac arrest of cardiac origin: a propensity-matched study and predictor analysis.
Encouraging results of extracorporeal cardiopulmonary resuscitation for patients with refractory cardiac arrest have been shown. However, the independent impact on the neurologic outcome remains unknown in the out-of-hospital population. Our objective was to compare the neurologic outcome following extracorporeal cardiopulmonary resuscitation and conventional cardiopulmonary resuscitation and determine potential predictors that can identify candidates for extracorporeal cardiopulmonary resuscitation among patients with out-of-hospital cardiac arrest of cardiac origin. ⋯ Extracorporeal cardiopulmonary resuscitation can improve neurologic outcome after out-of-hospital cardiac arrest of cardiac origin; furthermore, pupil diameter on hospital arrival may be a key predictor to identify extracorporeal cardiopulmonary resuscitation candidates.