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To determine the effects on hemodynamics, laboratory parameters, and renal function of terlipressin used in septic-shock patients with hypotension not responsive to high-dose norepinephrine (>2.0 microg x kg(-1) x min(-1)) and dopamine (25 microg x kg(-1) x min(-1)), a prospective, open-label study was carried out in 17 patients. Patients received one or(More)
OBJECTIVE To compare, in patients with hyperdynamic septic shock, the effects of norepinephrine or terlipressin on hemodynamic variables and renal function. DESIGN Prospective, randomized, open-label study. SETTING Intensive care unit of a university, tertiary, and referral center. PATIENTS Twenty adult patients with hyperdynamic septic shock, after(More)
BACKGROUND Lung-protective ventilation with the use of low tidal volumes and positive end-expiratory pressure is considered best practice in the care of many critically ill patients. However, its role in anesthetized patients undergoing major surgery is not known. METHODS In this multicenter, double-blind, parallel-group trial, we randomly assigned 400(More)
BACKGROUND The renal effect of hydroxyethylstarch (HES) solutions remains controversial. We hypothesized that the use of HES with a mean molecular weight of 130 kDa would reduce renal dysfunctions in the recipients. Our study was aimed at comparing the effects of two fluid regimens (HES 130/0.4 or HES 200/0.6) used for the resuscitation of brain-dead donors(More)
In severe sepsis, guidelines recommend de-escalating the empirical antimicrobial treatment as soon as the microbiological results are available. We aimed to determine the rate of de-escalation of the empirical antimicrobial treatment in neutropenic patients with severe sepsis. The characteristics of antimicrobial treatment associated with de-escalation and(More)
Antimicrobial de-escalation (ADE) is a strategy to reduce the spectrum of antimicrobials and aims to prevent the emergence of bacterial resistance. We present a systematic review describing the definitions, determinants and outcomes associated with ADE. We included 2 randomized controlled trials and 12 cohort studies. There was considerable variability in(More)
STUDY OBJECTIVES To determine whether the rate of acquisition of bacteriuria differs between the use of a complex closed drainage system (CCDS) with a preattached catheter, antireflux valve, drip chamber, and povidone-iodine releasing cartridge, and a two-chamber open drainage system (TCOS) in ICU patients. DESIGN Prospective, nonrandomized, controlled(More)
OBJECTIVE To assess the adequacy of empirical antimicrobial therapy prescribed in septic shock patients and to evaluate the relationship between inadequate antimicrobial therapy and 30-day mortality. DESIGN Prospective observational study. SETTING Medical-surgical (16-bed) intensive care unit in an urban teaching hospital. PATIENTS A total of 107(More)
OBJECTIVE To assess the effect on outcome (1 yr) of decompressive craniectomy performed within or after the first 24 hrs post-trauma in severely head-injured trauma patients with intractable cerebral hypertension. DESIGN Retrospective cohort study. SETTINGS Intensive care unit of a university hospital. PATIENTS Among 816 patients with severe head(More)
INTRODUCTION To investigate whether respiratory variation of inferior vena cava diameter (cIVC) predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure (ACF). METHODS Forty patients with ACF and spontaneous breathing were included. Response to fluid challenge was defined as a 15% increase of subaortic velocity time(More)