Search results for "critical care and intensive care medicine"

Influence of respiratory rate and end-expiratory pressure variation on cyclic alveolar recruitment in an experimental lung injury model

2012

Introduction Cyclic alveolar recruitment/derecruitment (R/D) is an important mechanism of ventilator-associated lung injury. In experimental models this process can be measured with high temporal resolution by detection of respiratory-dependent oscillations of the paO2 (ΔpaO2). A previous study showed that end-expiratory collapse can be prevented by an increased respiratory rate in saline-lavaged rabbits. The current study compares the effects of increased positive end-expiratory pressure (PEEP) versus an individually titrated respiratory rate (RRind) on intra-tidal amplitude of Δ paO2 and on average paO2 in saline-lavaged pigs. Methods Acute lung injury was induced by bronchoalveolar lavag…

Factores predictores de mortalidad y estrategias de detección precoz de síndrome hepatopulmonar en pacientes trasplantados hepáticos

2016

ResumenIntroducciónEl síndrome hepatopulmonar (SHP) es una enfermedad grave y progresiva cuya fisiopatología reside en un shunt intrapulmonar con hipoxia y deterioro clínico severo. Como único tratamiento efectivo se ha postulado el trasplante hepático (TH), en pacientes adecuadamente seleccionados.ObjetivoReconocer la importancia del diagnóstico temprano del SHP.Pacientes y métodosMediante un estudio observacional, descriptivo, con carácter retrospectivo de 8 pacientes con SHP, a los que se les realizó TH en el período entre abril del 2006 y agosto del 2014. Se han revisado los datos clínicos previos al trasplante y el seguimiento tras este.Se empleó un estudio multivariante (stepwise forw…

Neuro-ICU patient disposition

2018

This article revises the recent evidence on ICU admission criteria for acute neurological patients [traumatic brain injury (TBI) patients, postoperative neurosurgical procedures and stroke].The appropriate utilization of ICU beds is essential, but it is complex and a challenge to attain. To date there are no widely accepted international guidelines for managing these acute brain-injured patients (stroke, TBI, postneurosurgery) in the ICU. The criteria for ICU admission after neurological acute injury, high-dependency unit or a specialized neurosurgical ward vary from institution to institution depending on local structures and characteristics of the available resources. Better evidence to s…

Staphylococcus aureus alpha toxin mediates polymorphonuclear leukocyte-induced vasocontraction and endothelial dysfunction.

2002

The effect of Staphylococcus aureus alpha toxin (alpha-toxin) on selectin-mediated neutrophil adhesion was investigated in polymorphonuclear leukocyte- (PMN) induced vasocontraction and endothelial dysfunction. Adherence of human PMNs to rat aortic endothelium increased significantly following stimulation of the endothelium with alpha-toxin (0.1, 0.5, and 1 microg/mL). This effect could be significantly attenuated by monoclonal antibodies directed against P-selectin or fucoidin, a carbohydrate known to block selectins. Unstimulated human PMNs (10(6)cells/mL) were added to organ chambers containing rat aortic rings stimulated with alpha-toxin (0.5 microg/mL). PMNs elicited a significant vaso…

Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study

2022

Supported by Centro de Investigación Biomédica en Red (CIBER)‑Enfermedades respiratorias, Madrid, Spain (CB17/06/00021) and Fundación para el Fomento en Asturias de la Investigación Científica aplicada y la tecnología (FICYT, AYUD2021/52014). RRG is the recipient of a grant from Instituto de Salud Carlos III, Madrid, Spain (CM20/00083).

¿Está todo dicho sobre la vía aérea difícil? Otros enfoques son posibles

2009

Die fiberendoskopische Intubation: Ausbildung in der Technik

1995

Recommendations for uniform reporting of data following major trauma — the Utstein style

1999

Members: W.F. Dick (Co-Chairman) (Germany); P.J.F. Baskett (Co-Chairman) (UK); C.M. Grande (USA); H. Delooz (Belgium); W. Kloeck (South Africa); C. Lackner (Austria); M. Lipp (Germany); W. Mauritz (Austria); M. Nerlich (Germany); J. Nicholl (UK); J.P. Nolan (UK); P. Oakley (UK); M.J.A. Parr (UK), A. Seekamp (Belgium); E. Soreide (Norway); P.A. Steen (Norway); Luc van Camp (Belgium); B. Wolcke (Germany); D. Yates (UK).

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study.

2023

Purpose: In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods: We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results: 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters…

Ultrasound-Guided Infraclavicular Axillary Vein Versus Internal Jugular Vein Cannulation in Critically Ill Mechanically Ventilated Patients: A Random…

2022

OBJECTIVES: This clinical trial aimed to compare the ultrasound-guided in-plane infraclavicular cannulation of the axillary vein (AXV) and the ultrasound-guided out-of-plane cannulation of the internal jugular vein (IJV). DESIGN: A prospective, single-blinded, open label, parallel-group, randomized trial. SETTING: Two university-affiliated ICUs in Poland (Opole and Lublin). PATIENTS: Mechanically ventilated intensive care patients with clinical indications for central venous line placement. INTERVENTIONS: Patients were randomly assigned into two groups: the IJV group (n = 304) and AXV group (n = 306). The primary outcome was to compare the IJV group and AXV group through the venipuncture an…