Báo cáo y học: "Clinical information systems in the intensive care unit: primum non nocere" ppt

... time by changing the format of the ward round, thisis an issue that needs to be recognized, anticipated, andCommentaryClinical information systems in the intensive care unit: primum non nocereStephen ... byMorrison and colleagues [1] provides an important insightinto another potential problem introduced by computing tech-nology in the ICU. These investigators evaluated the effect of the introduction ... computing technology is highlighted. In critical care, as in other areas of health care, clinicians arefaced with rising health care costs and aging and increasinglycomplex patients. Furthermore,...

Báo cáo y học: "Dose of dialysis in the intensive care unit: is the venom in the dose or in the clinical experience" pdf

... year. The ‘dose ofexperience’ with RRT in the ICU might be a greaterdetermining factor of outcome in critically ill acute kidneyinjury patients than the dose of dialysis.Finally, despite the ... in the study by Vesconi and colleagues. Interestingly, there wasalso no difference in obtained net ultrafiltration between lowand intensive dose groups in the VA/NIH trial [7] and a studyby Tolwani ... week,targeting a Kt/V urea threshold. However, as long as weknow neither the nature nor the kinetics of many of the ‘toxins’involved in the acute ‘uraemic syndrome’ we will always haveto rely on...

Báo cáo y học: "Optimizing antibiotic therapy in the intensive care unit setting" pdf

... abstractsof nosocomial infection in intensive care units in Europe:results of the European Prevalence of Infection in Intensive Care (EPIC) Study; EPIC International Advisory Committee.JAMA 1995, ... resistance is similarly lacking[38]. Nevertheless, there is some indirect evidence that the use of combination antimicrobial therapy may be useful. In the County of Northern Jutland, Denmark, ... Using such data canimprove the efficacy of antimicrobial therapy by increasing the likelihood for adequate initial treatment of infections [6].Antimicrobial de-escalationThere is increasing...

Báo cáo y học: " Clinical review: Vasculitis on the intensive care unit – part 1: diagnosis" doc

... proteinare typical findings, but they add little in determining the specific diagnosis. The urea and creatinine can varyenormously, and premorbid values are particularly important in interpreting ... Pragmatically, becausedistinguishing WG from MPA does not change therapy in the ICU, it is only necessary to identify the presence of a smallvessel vasculitis and not to classify it. By using testing ... in the manner of their presentation to the ICU.Typically, this involves the lungs or kidneys, or both, although the heart, central nervous system and gastrointestinal tractcan also all be involved....

Báo cáo y học: "Clinical review: Vasculitis on the intensive care unit – part 2: treatment and prognosis" ppsx

... tractGastrointestinal involvement may include diarrhoea, gastro-intestinal haemorrhage, or perforation, and this may beexacerbated, or indeed masked, by high-dose steroid therapy. In common with other ... died within 2 years;CSS was nearly universally fatal, with 50% of deaths within the first year. PAN had a 5-year survival of 13%, again withmost deaths occurring in the early stages of the disease.However, ... immunosuppressive therapy. In thissecond part of the review we consider the role played by the ICU in their treatment and look at the prognosis of the fulminantpresentations. Although there is a firm...

Báo cáo y học: "Acute kidney injury in the intensive care unit: current trends in incidence and outcome" potx

... Changes in the incidence and outcome forearly acute injury in a cohort of Australian intensive care units.Crit Care 2007, 11:R68.2. Ympa YP, Sakr Y, Reinhart K, Vincent JL: Has mortality fromacute ... rely on, and improve, the clinical clock. Currently,consensus definitions for AKI exist and are being increasinglyused in the literature [7,8]. The advent of RIFLE (Risk-Injury-Failure-Loss of ... andAKIN (Acute Kidney Injury Network) criteria provides us aframework for identifying and staging AKI. This will not onlyaid us in recruiting patients, but also serve as clinicalendpoints...

Báo cáo y học: "Pharmacotherapeutic friendly fire in the intensive care unit: high stakes seeking high calibre" doc

... accountability is mediated through the administratorscontributing to the implicated system-level errors.CommentaryPharmacotherapeutic friendly fire in the intensive care unit: highstakes seeking high ... purposes)Available online http://ccforum.com/content/12/2/137AbstractIncreasing numbers of patients are surviving the intensive care unit.Concordant with our shifting focus to minimizing intensive care unit-acquired ... process. They discuss vulnerability,error definition and measurement, and methods to improve the process and outcomes of pharmacotherapy in the ICU. The ICU represents the meeting of the high-risk...

Báo cáo y học: "Tight glycaemic control in the intensive care unit: pitfalls in the testing of the concept" docx

... further aggravating the problem of power, the studyturned out to realize intensive insulin therapy, but without tightglycaemic control. The median morning blood glucose level in the intensive treatment ... BouillonR: Intensive insulin therapy in the medical ICU. N Engl J Med2006, 354:449-461.4. Krinsley JS: Effect of an intensive glucose management proto-col on the mortality of critically ill adult ... than the preset target of 80 to 110 mg/dL(4.4 to 6.1 mM). As a result, only 39.4% of the patients in the intensive treatment groups remained within range for theirentire ICU stay, whereas in the...

Báo cáo y học: "Patients with diabetes in the intensive care unit; not served by treatment, yet protected" pptx

... reported in the previous issue of Critical Care, Vincent and colleagues [1] investigated the possible increased risk of patients with insulin-treated diabetes for morbidity and mortality in the intensive ... morbidity and development of complications in diabetes can be explained by the often pre-existing organ dysfunction and pathophysiological alterations in the disease.  is raises the intriguing ... only of patients with a history of insulin-treated diabetes.  is deﬁ nition does not classify between type 1 and type 2 diabetes, and from the large type 2 diabetes population, only the insulin-treated...

Báo cáo y học: " Blood glucose control in the intensive care unit: discrepancy between belief and practice" potx

... Hyperglycemia in Pediatric Intensive Care) trial in the UK, will provide further knowledge about this intriguing topic. In conclusion, as shown by Preissig and Rigby, a majority of ICU physicians ... increases the workload and responsibility for bedside nurses. Frequent blood testing, interpretation of the blood glucose results, and ﬁ nally adapting the insulin infusion are very demand-ing ... MR: A disparity between physician attitudes and practice regarding hyperglycemia in pediatric intensive care units in the United States: a survey on actual practice habits. Crit Care 2010, 14:R11.2....

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