Articles: intensive-care-units.
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Large surveys auditing feeding regimen in the ICU consistently reported hypocaloric 23 enteral feedings patterns and many studies described the association between 24 energy deficit and increased complication rate. ESPEN and ASPEN experts 25 recommend early (after 48 h) or late (after 7-10 days) catch up of the 26 energy deficit with parenteral nutrition (PN) respectively, but the level of evidence 27 was poor and larger PRCT were missing. ⋯ However, weaknesses 30 in the study design and some mixing of the 3 questions have created confusion in the 31 message delivered. In addition, the severity of the acute illness was not always similar 32 in these studies, mixing short-term acutely ill patients (less than 4 days in the ICU) 33 with long term patients (more than 10 days in the ICU).
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Journal of critical care · Apr 2012
Prevalence and significance of lactic acidosis in diabetic ketoacidosis.
The prevalence and clinical significance of lactic acidosis in diabetic ketoacidosis (DKA) are understudied. The objective of this study was to determine the prevalence of lactic acidosis in DKA and its association with intensive care unit (ICU) length of stay (LOS) and mortality. ⋯ Lactic acidosis is more common in DKA than traditionally appreciated and is not associated with increased ICU LOS or mortality. The positive correlation of lactate with glucose raises the possibility that lactic acidosis in DKA may be due not only to hypoperfusion but also to altered glucose metabolism.
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To determine the frequency of admission and its reasons, severity and outcome among elderly patients in our intensive care unit (ICU) and compare them with those for younger subjects. ⋯ The management of elderly subjects remains a problem in intensive care. High mortality is generally not directly related to their age but rather to their overall condition.
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To evaluate the frequency of severe thrombocytopenia (STCP) (≤ 50,000/μl) in the first 24 hours in patients with multiple organ dysfunction syndrome, and the factors that influence its occurrence. ⋯ The prevalence of STCP among critical patients was 6.3%. Its occurrence was associated with albumin and bilirubin levels, sepsis, and with patient admittance in the last year.