Articles: outcome.
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Review Meta Analysis
Predictors of favourable outcome after in-hospital cardiac arrest treated with extracorporeal cardiopulmonary resuscitation: a systematic review and meta-analysis.
To identify the predictors of survival to discharge in adults resuscitated with extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest (IHCA). ⋯ In adult IHCA treated with ECPR a shockable initial rhythm, a lower low-flow time, lower blood lactate levels before ECPR start or on ICU admission, and a lower SOFA score or creatinine levels in the first 24h after ICU admission were associated with a higher likelihood of survival. These factors could help identifying patients who are eligible for ECPR.
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Randomized Controlled Trial
Is the Pelvic Examination Still Crucial in Patients Presenting to the Emergency Department With Vaginal Bleeding or Abdominal Pain When an Intrauterine Pregnancy Is Identified on Ultrasonography? A Randomized Controlled Trial.
We determine whether omitting the pelvic examination in emergency department (ED) evaluation of vaginal bleeding or lower abdominal pain in ultrasonographically confirmed early intrauterine pregnancy is equivalent to performing the examination. ⋯ Although there was only a small difference between the percentage of patients experiencing the composite morbidity endpoint in the 2 study groups (2.4%), the resulting 90% CI was too wide to conclude equivalence. This may have been due to insufficient power. Patients assigned to the pelvic examination group reported feeling uncomfortable more frequently.
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Multicenter Study Observational Study
Quality of fracture reduction assessed by radiological parameters and its influence on functional results in patients with pilon fractures-A prospective multicentre study.
The management of pilon fractures remains a challenging issue. Due to the complexity of factors that influence the outcome, it has been questioned if anatomical reductions of articular fracture are relevant. The lack of a commonly accepted assessment of quality of fracture reduction compounded the uncertainty of the importance of anatomical reduction in pilon fracture. The current study aimed to define parameters that can better assess the reduction quality and to investigate the influence of reduction quality on functional outcomes. ⋯ The multivariable analysis showed that LLM (independent of age, AO/OTA fracture type, and open/closed injury) was a reliable indicator of reduction quality and a prognostic factor for patient outcome in pilon fracture surgery.
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Endoscopic Submucosal Dissection for Superficial Proximal Esophageal Neoplasia is Highly Successful.
The aim of this study was to evaluate the outcomes of endoscopic submucosal dissection (ESD) for superficial proximal esophageal neoplasia. ⋯ ESD for the superficial proximal esophageal neoplasia is a safe and a very effective treatment method with a 100% 5-year disease-specific survival rate.
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Critical care medicine · Dec 2017
Time Course of Septic Shock in Immunocompromised and Nonimmunocompromised Patients.
To address the impact of underlying immune conditions on the course of septic shock with respect to both mortality and the development of acute infectious and noninfectious complications. ⋯ The underlying immune status impacts on the course of septic shock and on the susceptibility to ICU-acquired complications. This emphasizes the complexity of sepsis syndromes in relation with comorbid conditions and raises the question of the relevant endpoints in clinical studies.