Articles: critical-care.
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Multicenter Study Comparative Study
Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study.
Albumin administration in the critically ill has been the subject of some controversy. We investigated the use of albumin solutions in European intensive care units (ICUs) and its relationship to outcome. ⋯ Albumin administration was associated with decreased survival in this population of acutely ill patients. Further prospective randomized controlled trials are needed to examine the effects of albumin administration in sub-groups of acutely ill patients.
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Critical care medicine · Jan 2005
Multicenter StudyIncidence of acute respiratory distress syndrome in German children and adolescents: a population-based study.
The objective of this study was to determine the epidemiology of acute respiratory distress syndrome (ARDS) in children and adolescents aged 1 mo to 18 yrs. ⋯ This is the first population-based evaluation of the incidence of ARDS in the pediatric age group. It shows that the incidence of ARDS in this age group is low. This makes randomized studies on pediatric ARDS aiming on the end point "outcome" nearly impossible.
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Critical care medicine · Jan 2005
Multicenter Study Comparative StudyAirway pressures, tidal volumes, and mortality in patients with acute respiratory distress syndrome.
To determine the usual practice for setting tidal volume and other ventilatory parameters in patients with acute respiratory distress syndrome (ARDS) in the late 1990s and to determine the independent effects of these practices on intensive care unit mortality. ⋯ This descriptive study demonstrated considerable interpatient variability in tidal volumes during the study period. In addition to traditional prognostic indicators, timing of ARDS onset and the use of low levels of positive end-expiratory pressure or no positive end-expiratory pressure during the first week may adversely influence outcome in ARDS patients.
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Multicenter Study
Evaluation of the Paediatric Index of Mortality in children managed on adult intensive care units.
To evaluate the performance of the Paediatric Index of Mortality (PIM) in children cared for in adult intensive care units (ICUs) in district general hospitals in the South West Region of England. ⋯ PIM performs well as a risk adjustment method in children whose entire care remains in the adult ICU of a district general hospital. This is important should the Paediatric Intensive Care Audit Network (PICAnet) decide to extend its data collection beyond paediatric intensive care units to other units caring for critically ill children.
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Multicenter Study
Antibiotic-treated infections in intensive care patients in the UK.
The purpose of this audit was to study reasons for starting antibiotic therapy, duration of antibiotic treatment, reasons for changing antibiotics and the agreement between clinical suspicion and microbiological results in intensive care practice. We conducted a multicentre observational audit of 316 patients. Data on demographic details, site, treatment and nature of infection were collected. ⋯ Gram-negative organisms were the most common cause of proven infections (n = 90 (50%)). The antibiotic spectrum was narrowed in light of microbiology results in 78 patients (43%) and changed due to antibiotic resistance in 38 patients (21%). We conclude that the mean duration of treatment contrasts with existing published guidelines, highlighting the need for further studies on duration and efficacy of treatment in intensive care.