Medicina intensiva
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Letter Case Reports
[Systemic capillary leak syndrome: report of a case].
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Multicenter Study
[Extracorporeal lung support in patients with severe respiratory failure secondary to the 2010-2011 winter seasonal outbreak of influenza A (H1N1) in Spain].
To describe the use of extracorporeal membrane oxygenation (ECMO) in refractory respiratory failure. ⋯ The use of ECMO in refractory respiratory failure in patients with influenza A (H1N1) is rare in Spain. The hospital survival achieved with its use allows it to be regarded as a possible rescue technique in these patients.
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Cerebral microdialysis, introduced in experimental studies 40 years ago, has been used clinically since 1992 for the neurochemical monitoring of patients in intensive care. The principles underlying this technique are closely related to brain metabolism. The study of the metabolites detected at brain interstitial tissue level, through the semipermeable membrane of the device, allows us to assess different physiological pathways in the brain, analyzing the changes that occur when they become less efficient in terms of energy, and also detecting waste products secondary to tissue damage. Despite its current limitations, this technique provides relevant information for research and the clinical management of critical neurological patients.
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Clinical Trial
[Prognostic value of procalcitonin, C-reactive protein and leukocytes in septic shock].
This study evaluates the potential prognostic value of serial measurements of different biomarkers (procalcitonin [PCT], C-reactive protein and leukocytes [CRP]) in septic shock patients. ⋯ Serial procalcitonin measurements are more predictive of the prognosis of septic shock patients than single measurements of this parameter. The prognostic reliability of the latter is also better than in the case of C-reactive protein and leukocytes. The application of serial procalcitonin measurements may allow the identification of those septic patients at increased mortality risk, and help improve their treatment.
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The validation in critical patients with short-term catheters of a method for diagnosing catheter-related bloodstream infection (CR-BSI), based on the differential time to positivity (DTP) of blood cultures. ⋯ DTP can be a valid method for CR-BSI diagnosis in critically ill patients, avoiding unnecessary catheter withdrawal.