Medicina intensiva
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Case Reports
Cranioplasty with bandaging. new forms of limitation of life support and organ donation.
Most of transplanted organs are obtained from brain death (BD) donors. In neurocritical patients with catastrophic injuries and decompressive craniectomy (DC), which show a dreadful development in spite of this treatment, DC could be a futile tool to avoid natural progress to BD. We propose if cranial compressive bandage (cranioplasty with bandage) could be an ethically correct practice, similar to other life-sustaining treatment limitation (LSTL) common methods. Based on a clinical case, we contacted with the Assistance Ethics Committee and some bioethics professionals asking them two questions: 1) Is ethically correct to perform a cranioplasty with bandage in those patients with LSTL indication? 2) Thinking in organ donation possibility, is this option preferable? Conclusions 1) Cranioplasty with bandage could be considered an ethically acceptable LSTL practice, similar to other procedures. 2) It facilitates organ donation for transplant, which provides value-added because of its own social good. 3) In these cases, it is necessary to know previous patient's will or, in absentia, to obtain family consent after a detailed procedure report.
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Observational Study
[Usefulness of procalcitonin upon admission to intensive care in the diagnosis and prognosis of sepsis].
To assess the usefulness of procalcitonin (PCT) upon admission to the Intensive Care Unit (ICU) in the diagnosis and prognosis of sepsis ⋯ PCT upon admission to the ICU is useful for the diagnosis of sepsis, and is more effective than PCR in this respect. However, it is of no help in estimating the short-term prognosis.
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Observational Study
[Evaluation of the efficiency of care in the ICU].
To evaluate the efficiency of care in the ICU using a predictive model. ⋯ The model developed in this study was a good predictor of actual ICU-LOS, and both LOS and mortality analysis could be a good tool for ICU care evaluation.
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Letter Case Reports
[Non-atherosclerotic acute myocardial infarction: coronary artery embolism].