Critical care : the official journal of the Critical Care Forum
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Editorial Multicenter Study Observational Study
Impact on survival of whole-body computed tomography before emergency bleeding control in patients with severe blunt trauma.
Whole-body computed tomography (CT) has gained importance in the early diagnostic phase of trauma care. However, the diagnostic value of CT for seriously injured patients is not thoroughly clarified. This study assessed whether preoperative CT beneficially affected survival of patients with blunt trauma who required emergency bleeding control. ⋯ CT performed before emergency bleeding control might be associated with improved survival, especially in severe trauma patients with TRISS Ps of <50%.
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Multicenter Study
Kinetics of circulating immunoglobulin M in sepsis: relationship with final outcome.
The aim of this study was to investigate the kinetics of immunoglobulin M (IgM) during the different stages of sepsis. ⋯ Specific changes of circulating IgM occur when patients with severe sepsis progress into septic shock. The distribution of IgM is lower among non-survivors.
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Multicenter Study Observational Study
Automated peritoneal lavage: an extremely rapid and safe way to induce hypothermia in post-resuscitation patients.
Mild therapeutic hypothermia (MTH) is a worldwide used therapy to improve neurological outcome in patients successfully resuscitated after cardiac arrest (CA). Preclinical data suggest that timing and speed of induction are related to reduction of secondary brain damage and improved outcome. ⋯ Using PL in post-CA patients results in a rapidly reached target temperature and a very precise maintenance, unprecedented in clinical studies evaluating MTH techniques. This opens the way to investigate the effects on neurological outcome and survival of ultra-rapid cooling compared to standard cooling in controlled trials in various patient groups.
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According to the World Health Organization, traumatic injuries worldwide are responsible for over 5 million deaths annually. Post-traumatic bleeding caused by traumatic injury-associated coagulopathy is the leading cause of potentially preventable death among trauma patients. ⋯ The STOP the Bleeding Campaign therefore aims to increase awareness of the phenomenon of post-traumatic coagulopathy and its appropriate management by publishing European guidelines for the management of the bleeding trauma patient, by promoting and monitoring the implementation of these guidelines and by preparing promotional and educational material, organising activities and developing health quality management tools. The campaign aims to reduce the number of patients who die within 24 hours after arrival in the hospital due to exsanguination by a minimum of 20% within the next 5 years.
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We summarize original research in the field of critical care nephrology accepted or published in 2012 in Critical Care and, when considered relevant or directly linked to this research, in other journals. Three main topics have been identified for a rapid overview: acute kidney injury, detailed in some pathogenetic and epidemiological aspects; fluid overload as a predictor of mortality both in acute kidney injury and renal replacement therapy (RRT) patients; and RRT, evaluating some features of citrate anticoagulation and describing the effects of RRT modalities or timing on survival.