Search results for "critical care and intensive care medicine"

A new approach using high volume blood patch for prevention of post-dural puncture headache following intrathecal catheter pump exchange.

2015

Background: In an observational study, complications of intrathecal catheter pumps necessitating surgical exchange were analyzed. Also the use of a high-volume prophylactic epidural blood patch (EBP) during surgery for preventing post-dural puncture headache (PDPH) with a follow-up for 1 year is described. Materials and Methods: In 22 patients with refractory chronic pain of cancer/noncancer origin or severe spasticity, who were receiving intrathecal morphine including adjuvants or baclofen for symptom relief, catheter exchange with or without pump was performed. In patients with documented symptoms of PDPH following initial intrathecal catheter implantation, a prophylactic EBP with a high …

Non-invasive ventilation in postoperative patients: A systematic review

2010

Background: Postoperative pulmonary complications, generally defined as any pulmonary abnormality occurring in the postoperative period, are still a significant issue in clinical practice increasing hospital length of stay, morbidity and mortality. Non-invasive ventilation (NIV), primarily applied in cardiogenic pulmonary edema, decompensated COPD and hypoxemic pulmonary failure, is nowadays also used in perioperative settings. Objective: Investigate the application and results of preventive and therapeutic NIV in postsurgical patients. Design: A systematic review. Data sources: Medical literature databases were searched for articles about "clinical trials," "randomized controlled trials" a…

Diagnostik der O2-Versorgung über den O2-Status des Blutes

1993

Cardiac arrest in special circumstances

2021

Purpose of review European Resuscitation Council Guidelines for Cardiopulmonary Resuscitation prioritize treatments like chest compression and defibrillation, known to be highly effective for cardiac arrest from cardiac origin. This review highlights the need to modify this approach in special circumstances. Recent findings Potentially reversible causes of cardiac arrest are clustered into four Hs and four Ts (Hypoxia, Hypovolaemia, Hyperkalaemia/other electrolyte disorders, Hypothermia, Thrombosis, Tamponade, Tension pneumothorax, Toxic agents). Point-of-care ultrasound has its role in identification of the cause and targeting treatment. Time-critical interventions may even prevent cardiac…

The European trauma course – trauma teaching goes European

2014

The World Health Organization (WHO) has identified trauma as the major health care challenge of our century, claiming more productive life years worldwide than any other disease [1]. In the European Union (EU), injury accounts for 15 % of all deaths before the age of 60 years and is the fourth most common cause of death, with more than 235,000 deaths each year from injuries, equating to 600 injury fatalities per day [2]. In children, adolescents and young adults, accident and injury rates are even higher, being the leading cause of death in these age groups. Mortality from trauma in the EU has fallen 20 % in the past 20 years, to a rate of 63.7 per 100,000 in 2010 [3]. This reduction is par…

CPR - Guidelines 2000. Neue internationale Richtlinien für die kardiopulmonale Reanimation

2001

The "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. An International Consensus an Science" are the first true international CPR guidelines in the history of resuscitation medicine. Experts from major international resuscitation organizations (International Liaison Committee on Resuscitation, ILCOR) achieved a consensus of recommendations which had to pass a rigorous review procedure applying the tools of evidence-based medicine: all proposed guidelines or guideline changes had to be based on critically appraised pieces of evidence which had to be integrated into a final class of recommendations. The most important changes compared to previous recommenda…

Higher levels of IgA and IgG at sepsis onset are associated with higher mortality: results from the Albumin Italian Outcome Sepsis (ALBIOS) trial

2021

Abstract Background The role of intravenous immunoglobulins (IVIG) during sepsis is controversial, as different trials on IVIG have observed inconsistent survival benefits. We aimed to elucidate the possible association and clinical significance between circulating levels of immunoglobulins. Methods In a subset of 956 patients with severe sepsis and septic shock of the multicentre, open-label RCT ALBIOS, venous blood samples were serially collected 1, 2, and 7 days after enrolment (or at ICU discharge, whichever came first). IgA, IgG and IgM concentrations were assayed in all patients on day 1 and in a subgroup of 150 patients on days 2 and 7. Ig concentrations were measured employing a tur…

Procalcitonin for the diagnosis of invasive candidiasis: what is the evidence?

2017

Abstracts Procalcitonin is a widely used marker for the evaluation of infection and sepsis and to guide antibiotic therapy. During the last decade, several studies evaluated its role and diagnostic performance as a surrogate marker for the identification of Candida spp. in suspected invasive candidiasis. A low serum level and a favorable negative predictive value are the main findings for procalcitonin in this setting. The aim of this report is to provide an updated brief summary of the evidence supporting the use of PCT for the management of invasive candidiasis.

Albumin replacement therapy in immunocompromised patients with sepsis - Secondary analysis of the ALBIOS trial

2021

Abstract Background The best fluid replacement strategy and the role of albumin in immunocompromised patients with sepsis is unclear. Methods We performed a secondary analysis of immunocompromised patients enrolled in the ALBIOS trial which randomized patients with severe sepsis or septic shock to receive either 20% albumin (target 30 g per liter or more) and crystalloid or crystalloid alone during ICU stay. Results Of 1818 patients originally enrolled, 304 (16.4%) were immunocompromised. One-hundred-thirty-nine (45.7%) patients were randomized in the albumin while 165 (54.2%) in the crystalloid group. At 90 days, 69 (49.6%) in the albumin group and 89 (53.9%) in the crystalloids group died…

LightCycler SeptiFast in early diagnosis of sepsis: our experience.

2009

The conventional sepsis diagnosis, using the cultivation technique, needs 24 hours for bacterial identification and 36 hours for fungal. The use of empiric therapy makes the growth of bacteria and fungi slower or may yield negative findings in many cases of septic shock. The molecular technique can contribute to a more rapid and specific diagnosis in septic patients. SeptiFast detects 26 bacterial and fungal species DNAs, using the PCR in real time and giving results after 6 hours. This is important for de-escalation therapy and beginning of appropriate antibiotic treatment. The aim of this study is to evaluate the sensibility and the specificity of the SeptiFast test versus traditional dia…