Medicina intensiva
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To compare discrimination and calibration of the modified Brussels score with the Simplified Acute Physiology Score version 3 (SAPS-3) in predicting mortality. ⋯ The modified Brussels score on day 1 offers excellent discrimination and calibration in predicting mortality in the RICU, comparable to that of the SAPS-3.
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The benefit of enteral nutrition in critically ill patients has been demonstrated by several studies, especially when it is started early, in the first 24-48h of stay in the Intensive Care Unit, and this practice is currently advised by the main clinical guidelines. The start of enteral nutrition is controversial in patients with hemodynamic failure, since it may trigger intestinal ischemia. However, there are data from experimental studies in animals, as well as from observational studies in humans that allow for hypotheses regarding its beneficial effect and safety. Interventional clinical trials are needed to confirm these findings.
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We must change how antibiotics are used and adopt proactive strategies, similar to those used to save endangered species. Preservation of the efficacy of antibiotics and to stabilization of antibiotic-susceptible bacterial ecosystems should be global goals.