management of aneurysmal subarachnoid haemorrhage in the neurointensive care unit

... within the cells during correction The net effect of KCl administration is that the retained strong anion (Cl–) stays extracellullar, whereas most of the retained strong cation disappears into the ... extracellular SID and ATOT, the final determinants of metabolic acid–base status, toward the SID and ATOT of the infused fluid The CO2TOT of infused fluid is worth mentioning separately First, it ... fluids in Stewart’s terms Fluids are administered into the physiological milieu Their in vivo properties can therefore be described using Stewart’s physical chemical language, in other words in terms...

Ngày tải lên: 12/08/2014, 20:20

... controlled for the limitations noted above when evaluating the ability of the SIG to predict mortality The findings of these two studies are unique in the sense that they are the first reports of SIG ... account the physicochemical principles of either the decreased ratio of sodium to chloride or the decreased difference between them With regard to plasma, the addition of normal saline increases the ... resulting in a reduction in the alkalinity of blood The Na+/Cl– ratio has been proposed as a simple way to delineate the contribution of chloride to the degree metabolic acidosis [30] In other...

Ngày tải lên: 12/08/2014, 22:22

... output in patients with various types of shock in the ICU [1,14] In agreement with the findings reported by Jannuzzi and coworkers in the present issue of Critical Care [1], previous investigators ... Competing interests The authors declare that they have no competing interests 17 Acknowledgements This work was supported by a grant of the Faculty of Clinical Medicine Mannheim, University of Heidelberg, ... regimens according to PAC information across the spectrum of critically ill patients Further clinical trials should lead to the establishment of treatment protocols for the use of PAC in this patient...

Ngày tải lên: 12/08/2014, 23:23

... echocardiograms from patients in the postoperative care unit to assess the role of TTE in thrombus identification in the left ventricle during the postoperative period The postoperative care unit receives both ... apex from the subcostal view because of the position of the transducer relative to the cardiac apex [22,23] In the fourth and fifth patients, extension of the surgical incision into the upper ... remains to be confirmed in a prospective study Page of 5 Conclusions There is clear value in using TTE imaging of the heart for the purpose of cardiovascular evaluation and optimization in the...

Ngày tải lên: 14/08/2014, 07:21

... occurred in the mid-point of the interval and adjusting for the length of the interval The cumulative person-years were estimated as the number of person-years in an interval plus any previous year These ... calculated by subtracting from the number of people in the previous interval the number of deaths occurring in that interval The number of person-years in each interval was calculated assuming that deaths ... informal care costs of cerebrovascular diseases in the United Kingdom using European and national sources [9,25-28] They extracted information on the proportion of care given by working age carers, the...

Ngày tải lên: 13/08/2014, 11:22

... with the use of adjuvant Imatinib while waiting for the final outcomes of ongoing trials • Laparoscopic surgery The change in nomenclature from leiomyosarcoma to GIST and the advent of Imatinib ... Results In spite of these developments the role of surgery itself has remained unchanged We present our experience of 16 cases managed in this institute since introduction of Imatinib Patient was ... as an incidental finding (patient 13 in our series) They are labelled as "benign" purely on the basis of their size and radiological appearance These tumours, particularly those located in the...

Ngày tải lên: 09/08/2014, 07:21

... remit of the local ethics committee Prior to introduction of CPOE, local standards of prescribing existed specifying the tenets of good practice, including the avoidance of the use of abbreviations ... to investigate the impact of CPOE, without decision support, on MEs in the critical care setting The data collected were viewed in terms of proportion of errors, patient outcomes arising from the ... non-intercepted and intercepted errors were combined) The limitations of this study and the potential for bias discussed previously must be borne in mind when interpreting these results Some of the...

Ngày tải lên: 25/10/2012, 10:39

... these units, usually on a one-week basis One month after the completion of the study, the ICIS was implemented in the two other remaining units Approval of the ethics committee was obtained; informed ... overdose of a beta-blocker, where rapid intervention of the clinical pharmacist intercepted the administration of this overdose The nonintercepted potential ADEs were mainly dosing errors or incompleteness ... safety, they are not discussed in detail The incidence of intercepted MPEs was four times lower in the C-U than in the PB-U A few of these errors concerned problems with trailed zeros, but most of them...

Ngày tải lên: 25/10/2012, 10:39

... patients, positioning the patient supine with the head elevated 30–45 degrees, suctioning measures including continuous suctioning of subglottic secretions, and minimizing the use of sedating or paralytic ... characteristics of pathogens causing HAP These findings suggest areas for intervention and for developing guideline for prevention and control of HAP in HCFs THESIS STRUCTURE The thesis consists of 129 ... molecular characteristics of pathogens causing HAP in the Intensive care unit of Bach Mai Hospital which is the area with the highest incidence density of healthcare associated infections among Vietnamese...

Ngày tải lên: 25/07/2014, 13:57

... obtained during monitoring in the intensive care unit (ICU) [5,6,8,9,11,13] When pericardial tamponade was suspected, 52% of our patients had a improvement of the CV SOFA score, with a rise in ... tamponade following cardiothoracic surgery in the intensive care unit Journal of Cardiothoracic Surgery 2011 6:79 Competing interests The authors declare that they have no competing interests Received: ... the intensive care unit (ICU), in order to study predictors of success of rethoracotomy [9] The amount of pericardial fluid recovered at rethoracotomy was in the same range as found in other...

Ngày tải lên: 10/08/2014, 09:21

... loudness of the alarms Analysing the significance of the alarm for the patient remains as the major difficulty commentary units have been conducted to examine the relevance of alarms in monitoring; they ... description of the signal composition is given in terms of its characteristics in time and frequency according to the level of priority, resulting in a sequence of notes in a distinctive rhythm ... existing monitors in the intensive care unit Crit Care Med 1997, 25:614–619 Chambrin MC, Ravaux P, Calvelo D, Jaborska A, Chopin C, Boniface B: Multicentric study of monitoring alarms in the adult...

Ngày tải lên: 12/08/2014, 18:21

... of the Intermountain Respiratory Intensive Care Unit and of the ShockTrauma/Intermountain Respiratory ICU, and to the Respiratory Care Department of the LDS Hospital, for collaboration during the ... of demeaning the clinical training of students and house officers, I Competing interests None declared Acknowledgements I am indebted to the medical, nursing, and respiratory therapy staffs of ... dehydration, thereby confusing the evaluation of the state of the ECF and the state of hydration [68] Cardiovascular evaluation is also (inappropriately) included in the evaluation of hydration, thereby...

Ngày tải lên: 12/08/2014, 18:21

... Japan) The treating clinicians were blinded to the PCT results, and those performing the PCT assays were blinded to the clinical status of the patient The PCT results were not available during the ... assessed for the presence of infection at admission, on day 2, and on the day of discharge or on the day of death Clinical assessment was the first step in diagnosing infection Cultures of urine, blood ... presence of infection, remains problematic in sepsis In 20–30% of patients, the infection site is never identified Neither imaging studies nor blood culture analysis can rule out the presence of infection...

Ngày tải lên: 12/08/2014, 19:21

... life-sustaining support Crit Care Med 2001, 29: 197-201 20 Anonymous: A definition of irreversible coma Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain ... aspects of end -of- life care in the ICU exist and have been written about at great length We should not let the exciting challenge of resolving areas of disagreement dissuade us from working on interventions ... Critical care: why there is no global bioethics J Med Philos 1998, 23:643-651 22 European Society of Intensive Care Medicine: International Consensus Conference in Intensive Care Medicine: Preliminary...

Ngày tải lên: 12/08/2014, 19:22

... and bilirubin, alanine aminotransferase and creatinine (Vitalab Flexor, Dieren, The Netherlands) were determined at baseline (15 before start of the study), immediately after sedative infusion ... have been raised regarding the use of BIS in the ICU concerning the widespread use of opioids (which reduces the validity of BIS) [15,16], interpretation difficulties in neurological diseases ... Pitfalls of monitoring sedation in the ICU with the bispectral index Anesthesiology 1998, 89:A461 Simmons LE, Riker RR, Prato BS, Fraser GL: Assessing sedation during intensive care unit mechanical...

Ngày tải lên: 12/08/2014, 19:22

... disorders Therefore, improving our understanding of the impact of RRT on acid–base disorders and gaining insights into the nature of such disorders and the mechanisms of action of RRT are important In ... the effect of HVHF on acid–base balance A strong focus is given to the clinical implications of these interventions, with the aim of helping clinicians better understand and manage the acid–base ... control individuals in an intensive care unit (P < 0.005; Fig 4) Accordingly, CVVHDF can be considered physiologically superior to IHD in the correction of metabolic acidosis The overwhelming superiority...

Ngày tải lên: 12/08/2014, 20:20

... serum insulin-like growth factor binding protein concentration both have AUCs of the ROC of about 0.8 (the latter being an indicator of hepatic insulin resistance or lack of insulin effect on the ... include frequent measurement of blood glucose, which implies adequate training of the nursing team After all, it is the members of the nursing team who have proven to be the most proficient in ... HGI, the sampling interval in the two groups should be comparable Indeed, when the number of measurements is reduced, this can dramatically alter the HGI, depending on the variability in the blood...

Ngày tải lên: 12/08/2014, 20:20

... substantial clinical importance in the ICU, whereas the significance of these thrombi may be debated by clinicians working outside the ICU setting Strengths of the survey include comprehensive lists of ... important in the intensive deep venous Patient factors considered by respondents to make acare unit setting thrombosis (DVT) clinically important in the intensive care unit setting The scale ... important in the intensive care unit setting thrombosis (DVT)considered by respondents to make a deep venous venous thrombosis (DVT) clinically important in the intensive care unit setting The scale...

Ngày tải lên: 12/08/2014, 20:20

... misleading to assume that [HCO3–] is an independent determinant of [H+] In fact, the independent determinants of [H+] in the blood are the strong ion difference [SID], the total concentration of ... the net difference in their charges The [SID] is defined as the difference between the sum of the major cations (Na+, K+, Ca2+, Mg2+) and the sum of the major anions (Cl–, SO4–, lactate) in the ... bicarbonate administration may cause a decrease in intracellular pH In fact, the findings of cellular and whole animal model studies examining the effects of bicarbonate infusion on intracellular...

Ngày tải lên: 12/08/2014, 20:20

... accord with the beliefs of the majority of transplant professionals, who favour the wishes of the individual over the family in determining donor status” [15], and with the lamentations of a recent ... discussions of these wishes with family members, feelings and beliefs of family members, the timing and nature of procedures involved in organ removal in the operating room, the opportunities for viewing ... Rothenberg DM, Sprung CL, Webb SA, Wlody GS, Hurford WE: Recommendations for end -of- life care in the intensive care unit: The Ethics Committee of the Society of Critical Care Medicine Crit Care...

Ngày tải lên: 12/08/2014, 20:20