Articles: patients.
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Multicenter Study Observational Study
Prospective External Validation of a Predictive Score for Postoperative Pulmonary Complications.
The 'Assess Respiratory Risk in Surgical Patients in Catalonia' risk score can predict post-operative pulmonary complications with adequate utility.
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Anesthesia and analgesia · Aug 2014
Multicenter StudySacroiliac joint radiofrequency ablation with a multilesion probe: a case series of 60 patients.
This retrospective case series of patients with refractory sacroiliac joint (SIJ) pain presents our first 77 SIJ radiofrequency ablation (RFA) procedures performed with a multilesion probe. Of these, 16 (20.8%) provided no relief; 55 (71.4%) provided >50% pain relief at 6 weeks; 42 (54.5%, 95% confidence interval, 42.8%-65.8%) provided >50% pain relief at 6 months; and 12 (15.6%) continued to provide >50% pain relief at 1 year. These results compare favorably to those published using other RFA techniques. In conclusion, more than half of our patients with refractory SIJ pain received some pain relief for at least 6 months after RFA.
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Critical care medicine · Aug 2014
Multicenter Study Observational StudyInitial Lactate and Lactate Change in Post-Cardiac Arrest: A Multicenter Validation Study.
Rate of lactate change is associated with in-hospital mortality in post-cardiac arrest patients. This association has not been validated in a prospective multicenter study. The objective of the current study was to determine the association between percent lactate change and outcomes in post-cardiac arrest patients. ⋯ Lower lactate levels at 0, 12, and 24 hours and greater percent decrease in lactate over the first 12 hours post cardiac arrest are associated with survival and good neurologic outcome.
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Multicenter Study
Inappropriate care in European Intensive Care Units: confronting views from nurses, junior and senior physicians.
ICU care providers often feel that the care given to a patient may be inconsistent with their professional knowledge or beliefs. This study aimed to assess differences in, and reasons for, perceived inappropriate care (PIC) across ICU care providers with varying levels of decision-making power. ⋯ ICU care providers agree that excessive care is a true issue in the ICU. However, they differ in the reasons for the PIC, reflecting the roles each caregiver has in the ICU. Nurses charge physicians with a lack of initiative and poor communication, whereas physicians more often ascribe prognostic uncertainty. Teaching ICU physicians to deal with prognostic uncertainty in more adequate ways and to promote ethical discussions in their teams may be pivotal to improving moral distress and the quality of patient care.
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Multicenter Study Observational Study
Exertional hypoxemia in stable COPD is common and predicted by circulating proadrenomedullin.
The prevalence of exertional hypoxemia in unselected patients with COPD is unknown. Intermittent hypoxia leads to adrenomedullin (ADM) upregulation through the hypoxia-inducible factor-1 pathway. We aimed to assess the prevalence and the annual probability to develop exertional hypoxemia in stable COPD. We also hypothesized that increased ADM might be associated with exertional hypoxemia and envisioned that adding ADM to clinical variables might improve its prediction in COPD. ⋯ Exertional desaturation is common and associated with poorer clinical outcomes in COPD. ADM improves prediction of exertional desaturation as compared with the use of FEV1% predicted alone.