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BACKGROUND Central venous catheter-associated bloodstream infections (CVC-BSI) are a frequent cause of morbidity and mortality in intensive care settings. Many strategies have been used to decrease the risk of CVC-BSI; however, few studies have explored the educational intervention as an approach to reduce the CVC-BSI rates. OBJECTIVE The purpose of this(More)
Fluids are considered the cornerstone of therapy for many shock states, particularly states that are associated with relative or absolute hypovolemia. Fluids are also commonly used for many other purposes, such as renal protection from endogenous and exogenous substances, for the safe dilution of medications and as "maintenance" fluids. However, a large(More)
Correct interpretation of the urinary sodium concentration (NaU) and its relation to renal function in critically ill patients is lacking. Our aim was to evaluate the relationship between simultaneous NaU value and serum creatinine (sCr). The hypothesis is that a NaU value greater than 140 mmol/l (normal equivalent value in plasma) is only found in patients(More)
BACKGROUND Platelet activation and consumption are common in critically ill patients and are associated with poorer prognosis. Mean platelet volume is a simple surrogate for platelet activation, with higher MPV being associated with worse clinical condition on a large array of clinical diagnoses. We therefore aimed to investigate associations between(More)
OBJECTIVE To describe the composition of metabolic acidosis in patients with severe sepsis and septic shock at intensive care unit admission and throughout the first 5 days of intensive care unit stay. DESIGN Prospective, observational study. SETTING Twelve-bed intensive care unit. PATIENTS Sixty patients with either severe sepsis or septic shock. (More)
Regional lung perfusion estimated by electrical impedance tomography in a piglet model of lung collapse. assessment of the regional match between alveolar ventilation and perfusion in critically ill patients requires simultaneous measurements of both parameters. Ideally, assessment of lung perfusion should be performed in real-time with an imaging(More)
Sepsis is a major cause of mortality and morbidity in intensive care units. Organ dysfunction is triggered by inflammatory insults and tissue hypoperfusion. The brain plays a pivotal role in sepsis, acting as both a mediator of the immune response and a target for the pathologic process. The measurement of brain dysfunction is difficult because there are no(More)
OBJECTIVE To compare the effects of 3 types of noninvasive respiratory support systems in the treatment of acute pulmonary edema: oxygen therapy (O2), continuous positive airway pressure, and bilevel positive pressure ventilation. METHODS We studied prospectively 26 patients with acute pulmonary edema, who were randomized into 1 of 3 types of respiratory(More)
PURPOSE To compare the evolution of standard base excess and serum lactate level between surviving and non surviving patients with severe sepsis and septic shock resuscitated with early goal-directed therapy. METHODS This is a retrospective study in an intensive care unit of a university tertiary hospital where 65 consecutive severe sepsis and septic(More)
OBJECTIVE To compare the effects of oxygen, continuous positive airway pressure (CPAP), and bilevel positive airway pressure (bilevel-PAP) on the rate of endotracheal intubation in patients with acute cardiogenic pulmonary edema. DESIGN Randomized, controlled trial. SETTING Tertiary hospital emergency room. PATIENTS We randomly assigned 80 patients(More)