Articles: critical-care.
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Anesthesia and analgesia · Oct 2000
Meta AnalysisThe good, the bad, and the ugly: should we completely banish human albumin from our intensive care units?
Human albumin is still widely used in critically ill patients for volume replacement therapy or for correcting hypoproteinemia. Most meta-analyses on the value of albumin administration are over 15 yr old and raise more questions than they answer. With the help of a MEDLINE analysis, we examined more recent studies in humans using albumin. Most of these studies have recommended a very cautious use of albumin in critically ill patients.
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Ann Fr Anesth Reanim · Jan 2000
Meta Analysis[Catheter-related nosocomial urinary infections in intensive care: physiopathology, epidemiology and prevention].
Nosocomial urinary tract infections associated with bladders catheters are common and poorly understood. Data on the prevention of urinary tract infections are numerous and heterogenous. This update article aimed at analysing mechanisms, epidemiology and prevention of these infections. ⋯ Catheter-associated urinary tract infections reflect the general hygiene policy, starting with nurse practice patterns at catheter insertion, and ending with antibio-therapy prescriptions by medical staff.
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Critical care medicine · Jan 1999
Meta Analysis Comparative StudyCrystalloids vs. colloids in fluid resuscitation: a systematic review.
To systematically review the effects of isotonic crystalloids compared with colloids in fluid resuscitation. ⋯ Overall, there is no apparent difference in pulmonary edema, mortality, or length of stay between isotonic crystalloid and colloid resuscitation. Crystalloid resuscitation is associated with a lower mortality in trauma patients. Methodologic limitations preclude any evidence-based clinical recommendations. Larger well-designed randomized trials are needed to achieve sufficient power to detect potentially small differences in treatment effects if they truly exist.
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Nutritional support has become a standard of care for hospitalized patients, but whether total parenteral nutrition (TPN) affects morbidity and mortality is unclear. ⋯ Total parenteral nutrition does not influence the overall mortality rate of surgical or critically ill patients. It may reduce the complication rate, especially in malnourished patients, but study results are influenced by patient population, use of lipids, methodological quality, and year of publication.
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Critical care clinics · Jul 1998
Meta AnalysisNutritional support in the critically ill patients. A critical review of the evidence.
Providing nutritional support has become a standard component of managing critically ill patients. While many studies have documented that providing nutritional support can change nutritional outcomes (e.g., amino acid profile, weight gain, nitrogen balance), data are lacking that demonstrate that nutrition actually influences clinically importance endpoints. This article systematically reviews and critically appraises the literature, examining the relationship between nutritional support and infectious morbidity and mortality in the critically ill patient. In addition, evidence-based recommendations are made.