Articles: critical-illness.
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Randomized Controlled Trial Multicenter Study
Daily chlorhexidine bathing to reduce bacteraemia in critically ill children: a multicentre, cluster-randomised, crossover trial.
Bacteraemia is an important cause of morbidity and mortality in critically ill children. Our objective was to assess whether daily bathing in chlorhexidine gluconate (CHG) compared with standard bathing practices would reduce bacteraemia in critically ill children. ⋯ Sage Products, US National Institutes of Health.
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J. Clin. Endocrinol. Metab. · Mar 2013
Randomized Controlled TrialImpact of early nutrient restriction during critical illness on the nonthyroidal illness syndrome and its relation with outcome: a randomized, controlled clinical study.
Both critical illness and fasting induce low circulating thyroid hormone levels in the absence of a rise in TSH, a constellation-labeled nonthyroidal illness syndrome (NTI). The contribution of restricted nutrition during critical illness in the pathophysiology of NTI remains unclear. ⋯ Tolerating nutrient restriction early during critical illness, shown to accelerate recovery, further aggravated the NTI. The statistical analyses suggested that the more pronounced peripheral inactivation of the thyroid hormone with nutrient restriction during critical illness could be a beneficial adaptation, whereas the lowering of T4 could be deleterious.
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Randomized Controlled Trial Multicenter Study
Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial.
Enteral nutrition (EN) is recommended for patients in the intensive-care unit (ICU), but it does not consistently achieve nutritional goals. We assessed whether delivery of 100% of the energy target from days 4 to 8 in the ICU with EN plus supplemental parenteral nutrition (SPN) could optimise clinical outcome. ⋯ Foundation Nutrition 2000Plus, ICU Quality Funds, Baxter, and Fresenius Kabi.
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Nephrol. Dial. Transplant. · Feb 2013
Randomized Controlled TrialUse of online blood volume and blood temperature monitoring during haemodialysis in critically ill patients with acute kidney injury: a single-centre randomized controlled trial.
Little is known about the clinical impact on cardiovascular stability during intermittent haemodialysis (IHD) for acute kidney injury (AKI) of online monitoring devices that control blood volume (BV) and blood temperature in the intensive care unit (ICU) setting. We compared different dialysis treatment modalities with or without these new systems among critically ill patients requiring IHD. ⋯ These results suggest that both actively controlled body temperature and UF profiled by online monitoring systems have no significant impact on the incidence of intradialytic hypotension in the ICU setting. Further research is needed before the use of these new sophisticated automatic methods can be applied routinely to the ICU setting.
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The Journal of pediatrics · Feb 2013
Randomized Controlled TrialHigh endogenous melatonin levels in critically ill children: a pilot study.
To evaluate the serum melatonin levels in critically ill pediatric patients and to test the effect of light on the melatonin's circadian rhythm. Data on melatonin secretion in critically ill pediatric subjects are lacking. ⋯ The high melatonin levels in the critically ill children may be a response to counteract the elevated oxidative stress associated with serious diseases. Whether these elevated melatonin levels confer any beneficial effects in pediatric critically ill patients remains unknown.