Báo cáo y học: "Recently published papers: Renal replacement therapy: which route and how much? Intracerebral haematomas: does the size matter? β blockers and steroids: will we ever know" doc

Báo cáo y học: " Recently published papers: Topical issues in pharmacology" pptx

... demonstrating profound and resistantvascular hyporeactivity. Bolus terlipressin resulted in aprogressive increase in mean arterial pressure, allowingwithdrawal of noradrenaline (norepinephrine) in ... was lower in thehydrocortisone group than in the placebo group (P < 0.05).No difference in mortality was found. Interleukin-6 andinterleukin-8 were both significantly reduced in the treatmentgroup, ... doses. In the absence of routine anti-factor Xa activity assays, some caution may be requiredbefore instituting blind dose increases for a group of patientswho are at risk of occult bleeding...

Báo cáo y học: " Recently published papers: We are what we eat" pot

... accelerate recovery ofgastrointestinal motility may be effective salt and waterbalance. In a study by Lobo and colleagues [4], prompted byCommentary Recently published papers: We are what we eat?LG ... recent study reported by Yapand coworkers [7]. They retrospectively studied more than1000 patients over an 18-month period, their hypothesisbeing that serum hypoalbuminaemia may be predictive ... predictive ofmortality risk in the critically ill. This was no doubt triggeredby the Acute Physiology and Chronic Health Evaluation(APACHE) III as well as the study reported by McCluskeyand colleagues...

Báo cáo y học: " Recently published papers: New evidence for old debates, new drugs and some timely reminders" pps

... reported by Weber and colleagues [22].Sadly, adoption of this technique, in the UK at least, awaitsthe deliberation of the government and judiciary.Finally, if you have been seduced by the attractive ... thedermal tolerance and user acceptability of six alcohol-basedhand disinfectants for hygienic hand disinfection. J HospInfect 2002, 51:114-120.25. Laffey JG, Kavanagh BP: Hypocapnia. N Engl ... death and myocardialinfarction within 30 days, in a large cohort of patients(n = 7033) with suspected acute coronary syndrome and both normal and reduced creatinine clearance. Afteradjustment for...

Báo cáo y học: "Recently published papers: of head injuries, high frequencies and haemodynamic optimization" pps

... mortality and transfusion. Vincent and colleagues used a propensity scoring system to identify twodistinct groups and control for confounders, and found anodds ratio of 1.37 for mortality in transfusion ... recommendations regarding plateau pressures.Kern and Shoemaker [11] recently looked back at thesuccesses of haemodynamic goal-directed therapy in a meta-analysis of randomized controlled studies aiming ... values in high- risk elective surgery, trauma and sepsis patients. Their findings confirmed further thatwhen therapy is aimed at improving oxygen delivery(especially in the severely ill, in...

Báo cáo y học: "Recently published papers: A number of treatment controversies" pptx

... These areimportant questions but they are not easily answered.Anxiolysis, analgesia, amnesia and sedation are just a few of the elements to be considered. It is now widely accepted thatunbridled ... the lack of consensus on which, if any, agent isbest and the wide variability on what is considered to be a good measure of best sedation. It is probably a case of notwhat you use but how you ... sedation, given with best of intentions, is harmful interms of ventilator and ICU days and consequently outcome,and that a sedation protocol including daily cessation of sedative agents is of...

Báo cáo y học: "Recently published papers: Changing practices in the modern intensive care unit" pps

... benefit to therapy directedby pulmonary artery catheters over standard care in this patientgroup. Indeed, there was a higher rate of pulmonary embolism in the catheter group than in the standard ... treatment arm. The physiological goals and treatment priorities in the pulmonaryartery catheter group were defined by the investigators before the study began, and assessment of achievement of thesegoals ... adopted with the sameenthusiasm as that of the balloon directed pulmonary arterycatheter in the early 1980s. There is some good news for the pulmonary artery catheter enthusiasts – there was no...

Báo cáo y học: "Recently published papers: small pieces of the puzzle and the long-term view" pps

... Theyreported an alarmingly high incidence of peripheralneurological deficits on examination (13/22, 59% of CommentaryRecently published papers: small pieces of the puzzle and the long-term viewJonathan ... study undoubtedly provides furtherevidence to support the enormous ongoing efforts to tacklethis phenomenon.ObesityAgainst the background of the global epidemic of obesity, the impact of body ... respiratorysyndrome) epidemic and a war in Iraq beamed live into ourdaily lives. The weekly medical journals have covered theseevents and contributed to the debates surrounding them.These events...

Báo cáo y học: "Recently published papers: inflammation, elucidation, manipulation" pps

... we may be able toalter and influence the underlying pathophysiology of sepsis.Many reports from those who believe that this may lie in thehypothalamic–pituitary–adrenal axis have recently been published. ... human sepsis? Timeand more research will tell.CommentaryRecently published papers: inflammation, elucidation, manipulation?Justin Kirk-Bayley1and Richard Venn21Research registrar, Anaesthesia ... scores do not.So will stress doses of hydrocortisone attenuate severesystemic inflammatory response syndrome after cardiacsurgery with cardiopulmonary bypass? Kilger and coworkers[3] would...

Báo cáo y học: "Recently published papers: Take your predictions with a drop of saline … and breathe deeply before turning on your phone" ppt

... spent on mechanical ventilation or inthe duration of renal replacement therapy between the twotreatment groups. The study was pragmatically planned,dictating only the fluid resuscitation of the ... the patients, leavingclinicians free to manage all other aspects of the patients’care as they saw fit. This freedom was controlled bystratification of randomization such that individual unitstreated ... of elective extubation,versus standard medical therapy. Those investigatorsdemonstrated that not only did NIV fail to prevent the needfor reintubation, but that it also delayed reintubation...

Báo cáo y học: "Recently published papers: The message is clear – start early" ppt

... days, ICU-free days, or organfailure-free days.Lactate clearanceFrom the emergency department in Detroit, home of earlygoal-directed therapy [5], comes another simple and elegantstudy of the ... medical therapy. The primary outcome measureswere ICU mortality and need for reintubation. The trial wasstopped at an interim analysis because of a statisticallysignificant increase in mortality ... cmH2O and the lowerlevel group 8.3 ± 3.2 cmH2O. The primary outcome measurewas in-hospital 60-day mortality. Not only was there nodifference in 60-day mortality, but also there was nodifference...

Báo cáo y học: "Recently published papers: Clunk-click every trip, smile, but don’t stop for a drink on the way" ppt

... standard therapy alone with standard therapy plus a maximum of four intratracheal doses of a recombinantsurfactant protein C-based surfactant given within 24 hours.They failed to demonstrate any ... papers: Clunk-click every trip, smile, but don’t stop for a drink on the wayJon Stacey1and Richard Venn21Senior House Officer, Department of Critical Care, Worthing General Hospital, Lyndhurst ... the study was powered only todemonstrate a reduction in pneumonia. Interestingly, the Kaplan–Meier curves of time to death appear to separate ataround the time of tracheotomy in the delayed group....

Báo cáo y học: " Recently published papers: A clinical conundrum, new from old and advances in ventilation'''' docx

... group was also shown.An equally unappetizing prospect is the combination of ARF and haematological malignancy. A further study appearing in Chest [14] compared NIV with invasive intubation and ventilation ... oxygentherapy alone in acute cardiogenic pulmonary oedema.Specifically, CPAP and BIPAP resulted in much improvedPaO2/FiO2ratios and a lower incidence of endotrachealintubation. No increased ... However, these findings were largely based on 28-daydata, and as such they do not take the entire hospital stayinto account. Laterre and coworkers point out that, at28 days, more than 40% of the...

Báo cáo y học: "Recently published papers: More about EGDT, experimental therapies and some inconvenient truths" potx

... ofbreathing a hydrogen oxygen atmosphere and half to nitrogenoxygen. The anti-inflammatory effects of the hydrogen werevery striking. The impracticality of repeating this study in anyclinical ... inmortality at 7, 14, 28 and 90 days, or indeed, serial sequentialorgan failure assessment (SOFA) score or a variety of haemo-dynamic end points. The study was prompted by limitedevidence, and a physiological ... mitochondrial therapies yet prove to be the therapies that end the optimalinopressor debate?Hydrogen?Staying in the realm of novel therapies, hydrogen may also bein ICUs in the future. My personal...

Báo cáo y học: "Recently published papers: Renal replacement therapy: which route and how much? Intracerebral haematomas: does the size matter? β blockers and steroids: will we ever know" doc

... only one country in the world”. However,patients in these series were predominantly undergoing majorvascular surgery and had documented wall motion abnormali-ties on dobutamine stress ECHO, and, ... becausetheir opinion was almost entirely based on the DECREASEseries [10] by Poldermans and colleagues, which were“mainly observational, done primarily only on vascular surgerypatients and in ... editorial, however,was heavily criticised by Dr London in his editorial [9], mostlybecause both of the authors were heavily involved in writingguidelines for the perioperative β blockade, and also...

Báo cáo y học: " Recently published papers: Renal support in acute kidney injury is low dose the new high dose" doc

... critically ill patients do, on occasion,require renal support in whatever guise whereas the mainstayCommentary Recently published papers: Renal support in acute kidney injury - is low dose the new high ... benefit.Finally, a study on cessation of therapy. A further subgroupanalysis of the BEST kidney data (Beginning and EndingSupportive Therapy for the Kidney) has examined the clinicalparameters ... clinicaloutcomes, although 88% of patients did achieve the lower dose regime. Increasing the intensity of therapy beyond the new high dose may not confer additional clinical benefit.Finally,...

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