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  • 1.
    Gogniat, Emiliano
    et al.
    Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
    Ducrey, Marcela
    Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
    Dianti, Jose
    Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
    Madorno, Matias
    Inst Tecnol Buenos Aires ITBA, Buenos Aires, DF, Argentina.
    Roux, Nicolas
    Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
    Midley, Alejandro
    Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
    Raffo, Julio
    Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
    Giannasi, Sergio
    Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
    San Roman, Eduardo
    Hosp Italiano Buenos Aires, Dept Intens Care Med, Buenos Aires, DF, Argentina.
    Suarez-Sipmann, Fernando
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. CIBERES, Madrid, Spain;Hosp Univ & Politecn La Fe, Serv Med Intens, Valencia, Spain.
    Tusman, Gerardo
    Hosp Privado Comunidad Mar Del Plata, Dept Anesthesiol, Mar Del Plata, Buenos Aires, Argentina.
    Dead space analysis at different levels of positive end-expiratory pressure in acute respiratory distress syndrome patients2018Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 45, s. 231-238Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VDBohr/VT) in patients with acute respiratory distress syndrome (ARDS).

    Material and methods: Fourteen ARDS patients under lung protective ventilation settingswere submitted to 4 different levels of PEEP (0, 6, 10, 16 cmH(2)O). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step.

    Results: Two groups of patients responded differently to PEEP when comparing baseline with 16-PEEP: those in which driving pressure increased > 15% (Delta P.(15%), n = 7, p = .016) and those in which the change was <= 15% (Delta P-<= 15%, n = 7, p = .700). VDBohr/VT was higher in Delta P-<= 15% than in Delta P-<= 15% patients at baseline ventilation [0.58 (0.49-0.60) vs 0.46 (0.43-0.46) p = .018], at 0-PEEP [0.50 (0.47-0.54) vs 0.41 (0.40-0.43) p = .012], at 6-PEEP [0.55 (0.49-0.57) vs 0.44 (0.42-0.45) p = .008], at 10-PEEP [0.59 (0.51-0.59) vs 0.45 (0.44-0.46) p = .006] and at 16-PEEP [0.61 (0.56-0.65) vs 0.47 (0.45-0.48) p =. 001]. We found a good correlation between Delta P and VDBohr/VT only in the Delta P.(15%) group (r = 0.74, p < .001).

    Conclusions: Increases in PEEP result in higher VDBohr/VT only when associated with an increase in driving pressure.

  • 2.
    Jonsson, Niklas
    et al.
    Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden.
    Gille-Johnson, Patrik
    Karolinska Inst, Dept Med, S-17177 Stockholm, Sweden.
    Martling, Claes-Roland
    Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden.
    Xu, Shengyuan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Venge, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Mårtensson, Johan
    Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden.
    Performance of plasma measurement of neutrophil gelatinase-associated lipocalin as a biomarker of bacterial infections in the intensive care unit2019Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 53, s. 264-270Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To assess the value of dimeric neutrophil-gelatinase associated lipocalin (NGAL) as an early marker of bacterial infection and its response to antibiotic therapy in intensive care unit (ICU) patients.

    Materials & methods: We measured daily plasma dNGAL in 198 patients admitted to a mixed ICU. Likelihood of infection was determined with International Sepsis Forum criteria. Wemeasured dNGAL in 145 healthy controls to establish normal values.

    Results: ICU patients had higher dNGAL than healthy controls. A suspected or confirmed infection was independently associated with 90% (95% CI 15-215%) higher dNGAL than absence of infection. We observed no association between acute kidney injury and dNGAL. Diagnostic accuracy at antibiotic treatment initiation, assessed with area under the receiver-operating characteristics curve (AUC-ROC), for dNGAL was 0.70 (95% CI 0.60-0.79). AUC-ROC for dNGAL 24 h before antibiotic treatment initiation was 0.54 (95% CI 0.41-0.66). The mean (95% CI) change of dNGAL in the first 2 days after appropriate antibiotic therapy initiation was -31 (-49,-13)%.

    Conclusions: In our cohort of ICU patients, plasma dNGAL was associated with presence of bacterial infections independent of AKI but it performed poor as a predictor of infections. Following antibiotic therapy, dNGAL markedly decreased-supporting further exploration of dNGAL-guided antibiotic de-escalation.

  • 3.
    Jung, Christian
    et al.
    Univ Hosp, Dep Cardiol Pulmonol & Angiol, Dusseldorf, Germany;Heinrich Heine Univ, Div Cardiol & Intens Care, Univ Hosp Dusseldorf, Dusseldorf, Germany;Univ Hosp Dusseldorf, Heinrich Heine Univ Dusseldorf, Med Fac, Div Cardiol Pulmonol & Vasc Med, Dusseldorf, Germany.
    Wernly, Bernhard
    Paracelsus Med Univ, Dept Cardiol, Salzburg, Austria.
    Muessig, Johanna M.
    Univ Hosp, Dep Cardiol Pulmonol & Angiol, Dusseldorf, Germany.
    Kelm, Malte
    Univ Hosp, Dep Cardiol Pulmonol & Angiol, Dusseldorf, Germany.
    Boumendil, Ariane
    Hop St Antoine, AP HP, Serv Reanimat Med, F-75012 Paris, France.
    Morandi, Alessandro
    Hosp Ancelle Cremona, Dept Rehabil, Geriatr Res Grp, Brescia, Italy.
    Andersen, Finn H.
    Alesund Hosp, Dep Anaesthesia & Intens Care, Alesund, Norway;NTNU, Dep Circulat & Med Imaging, Trondheim, Norway;Alesund Hosp, ICU, Alesund, Norway.
    Artigas, Antonio
    Autonomous Univ Barcelona, Dept Intens Care Med, CIBER Enjermedades Respiratorias, Corp Sanitaria Univ Parc Tauli, Sabadell, Spain;Univ Hosp Sagrad Corazon, Dept Intens Care Med, Barcelona, Spain;Univ Hosp Gen Catalunya, Barcelona, Spain.
    Bertolini, Guido
    IRCCS, Ist Ric Farmacol Mario Negri, Lab Epidemiol Clin, Ctr Coordinamento GiViTI,Dipartimento Salute Pubb, I-24020 Bergamo, Italy.
    Cecconi, Maurizio
    Humanitas Univ, Dept Anaesthesia, IRCCS, Inst Clin Humanitas, Milan, Italy.
    Christensen, Steffen
    Aarhus Univ Hosp, Dept Anaesthesia & Intens Care Med, Aarhus, Denmark;Aarhus Univ Hosp, Skejby, Denmark.
    Faraldi, Loredana
    Grande Osped Metropolitano Niguarda, Milan, Italy.
    Fjolner, Jesper
    Aarhus Univ Hosp, Dept Anaesthesia & Intens Care Med, Aarhus, Denmark;Randers Reg Hosp, ITA, Randers, Denmark.
    Lichtenauer, Michael
    Paracelsus Med Univ, Dept Cardiol, Salzburg, Austria.
    Bruno, Raphael Romano
    Univ Hosp, Dep Cardiol Pulmonol & Angiol, Dusseldorf, Germany.
    Marsh, Brian
    Mater Misericordiae Univ Hosp, Dublin, Ireland;Mater Misericordiae Univ Hosp, Dept Crit Care Med, Dublin, Ireland.
    Moreno, Rui
    Hosp Sao Jose, Ctr Hosp Lisboa Cent, Unidade Cuidados Intensivos Neurocrit, Fac Ciencia Med Lisboa,Nova Med Sch, Lisbon, Portugal.
    Oeyen, Sandra
    Ghent Univ Hosp, Dept Intens Care, 1K12IC, Ghent, Belgium;Ghent Univ Hosp, Dept Intensive Care, Ghent, Belgium.
    Ohman, Christina Agvald
    Karolinska Univ Hosp, Solna, Sweden.
    Pinto, Bernadro Bollen
    Geneva Univ Hosp, Geneva, Netherlands;Geneva Univ Hosp, Peri Intervent Intermidate Care SINPI, Geneva, Switzerland.
    Soliman, Ivo W.
    Univ Utrecht, Dept Intens Care Med, Univ Med Ctr, Utrecht, Netherlands.
    Szczeklik, Wojciech
    Jagiellonian Univ, Intens Care & Perioperat Med Div, Med Coll, Krakow, Poland;Univ Hosp Krakow, Dept Intens Care & Perioperat Med, Krakow, Poland.
    Valentin, Andreas
    Kardinal Schwarzenberg Hosp, Schwarzach, Austria.
    Watson, Ximena
    St Georges Univ Hosp, London, England.
    Zafeiridis, Tilemachos
    Gen Hosp Larissa Tsakalof Larissa, Intens Care Unit, Larisa, Greece.
    De Lange, Dylan W.
    Univ Utrecht, Dept Intens Care Med, Univ Med Ctr, Utrecht, Netherlands.
    Guidet, Bertrand
    Hop St Antoine, Hop Paris, Serv Reanimat Med, F-75012 Paris, France;UPMC Univ Paris 06, Sorbonne Univ, UMR S 1136, Inst Pierre Louis Epidemiol & Sante Publ, F-75013 Paris, France;INSERM, UMR S 1136, Inst Pierre Louis Epidemiol & Sante Publ, F-75013 Paris, France;Reanimat Med, St Antoine, France.
    Flaatten, Hans
    Univ Bergen, Dept Clin Med, Dept Anaestesia & Intens Care, Haukeland Univ Hosp, Bergen, Norway;Haukeland Hosp, Gen ICU, Bergen, Norway.
    Schmutz, Rene
    Hosp St John God Vienna, B5, Vienna, Austria.
    Wimmer, Franz
    Kardinal Schwarzenbergsches Krankenhaus, Schwarzach Im Pongau, Austria.
    Eller, Philipp
    Med Univ Graz, Intensivstn Univ, Klin Innere Med, Graz, Austria.
    Joannidis, Michael
    Univ Hosp Innsbruck, MICU, Innsbruck, Austria.
    De Buysscher, Pieter
    AZ Sint Lucas Ghent, Dept Intens Care, Ghent, Belgium.
    De Neve, Nikolaas
    OL Vrouwhosp Aalst, Aalst, Belgium.
    Swinnen, Walter
    AZ Sint Blasius Dendermonde, Dept Intens Care Med, Dendermonde, Belgium.
    Abraham, Paul
    Geneva Univ Hosp, Adult Intens Care SIA, Geneva, Switzerland.
    Hergafi, Leila
    Hop Fribourgeois, Serv Soins Intensifs, Fribourg, Switzerland.
    Schefold, Joerg C.
    Univ Bern, Univ Klin Intensivmed, Inselspital, Bern Univ Hosp, Bern, Switzerland.
    Biskup, Ewelina
    Univ Hosp Basel, Med ICU, Basel, Switzerland.
    Piza, Petr
    IKEM, KARIP, Prague, Czech Republic.
    Taliadoros, Ioannis
    Nicosia Gen Hosp, CY001, Aglandjia, Cyprus.
    Dey, Nilanjan
    Reg Hosp Herning, Intens Herning, Herning, Denmark.
    Solling, Christoffer
    Reg Hosp Viborg, Viborg, Denmark.
    Rasmussen, Bodil Steen
    Aalborg Univ Hosp, ICU, Aalborg, Denmark.
    Forceville, Xavier
    Ctr Hosp Meaux, Reanimat Med Chirurg, Meaux, France.
    Besch, Guillaume
    CHRU Besancon, Dept Anesthesie Reanimat Chirurg, Besancon, France.
    Mentec, Herve
    Ctr Hosp Victor Dupouy Argenteuil, Serv Reanimat Polyvalente, Argenteuil, France.
    Michel, Philippe
    CH Camelle Portes Oise, Beaumont Sur Oise, France;CH Rene Dubos, Reanimat Med Chirurg, Pontoise, France.
    Mateu, Philippe
    CH Charleville Mezieres, Reanimat Polyvalente, Charleville Mezieres, France.
    Vettoretti, Lucie
    CHRU Besancon, Reanimat Med, Besancon, France.
    Bourenne, Jeremy
    CHU Marseille Timone, Reanimat Urgences & Med, Marseille, France.
    Marin, Nathalie
    Hop Cochin, Reanimat Med, Paris, France.
    Guillot, Max
    Hop Hautepierre, Reanimat Med, Strasbourg, France.
    Aissaoui, Naida
    Hop Europeen Georges Pompidou, Reanimat Med, Paris, France.
    Goulenok, Cyril
    Hop Prive Jacques CARTIER, Reanimat Med, Massy, France.
    Thieulot-Rolin, Nathalie
    Hosp Marc Jacquet, Intens Care Med Dept, F-77000 Melun, France.
    Messika, Jonathan
    Louis Mourier, Reanimat Med Chirurg, Colombes, France.
    Lamhaut, Lionel
    Necker AP HP, Polyvalente Adult ICU, Paris, France.
    Charron, Cyril
    Univ Hosp Ambroise Pare, Med Surg ICU, Paris, France.
    Lauten, Alexander
    Charite Univ Med Berlin, Dept Cardiol, Berlin, Germany;Charite Univ Med Berlin, DZHK Berlin Partner Side, Berlin, Germany.
    Sacher, Anna Lena
    Charite Univ Med Berlin, Dept Anesthesiol, Berlin, Germany.
    Brenner, Thorsten
    Heidelberg Univ Hosp, Dept Anesthesiol, Heidelberg, Germany.
    Franz, Marcus
    Friedrich Schiller Univ, Jena Univ Hosp, Dept Internal Med, Jena, Germany.
    Bloos, Frank
    Friedrich Schiller Univ, Jena Univ Hosp, Dept Anesthesiol, Jena, Germany.
    Ebelt, Henning
    Catholic Hosp St Johann Nepomuk, Dept Med 2, Erfurt, Germany.
    Schaller, Stefan J.
    Tech Univ Munich, Klinikum Rechts Isar, Dept Anesthesiol, Munich, Germany.
    Fuest, Kristina
    Tech Univ Munich, Klinikum Rechts Isar, Dept Anesthesiol, Munich, Germany.
    Rabe, Christian
    Tech Univ Munich, Klinikum Rechts Isar, Dept Clin Toxicol, Munich, Germany.
    Dieck, Thorben
    Hosp Hannover, Med Sch, Dept Anaesthesiol & Intens Care, Hannover, Germany.
    Steiner, Stephan
    St Vincenz Krankenhaus Limburg, Dept Cardiol Pneumol & Intens Care, Limburg, Germany.
    Graf, Tobias
    Univ Heart Ctr Luebeck, Dept Cardiol, Lubeck, Germany.
    Nia, Amir M.
    Heinrich Heine Univ, Div Cardiol & Intens Care, Univ Hosp Dusseldorf, Dusseldorf, Germany.
    Janosi, Rolf Alexander
    Univ Hosp Essen, Dept Cardiol & Vasc Dis, Essen, Germany.
    Meybohm, Patrick
    Frankfurt Univ Hosp, Dept Anaesthesiol Intens Care Med & Pain Therapy, Frankfurt, Germany.
    Simon, Philipp
    Univ Hosp Leipzig, Dept Anaesthesiol & ICM, Leipzig, Germany.
    Utzolino, Stefan
    Univ Klinikum Freiburg, Dept Gen & Visceral Surg, Freiburg, Germany.
    Rahmel, Tim
    Univ Hosp Knappschaftskrankenhaus Bochum, Dept Anaesthesiol Intens Care Med, Bochum, Germany.
    Barth, Eberhard
    Univ Ulm, Dept Anaesthesiol, Ulm, Germany.
    Schuster, Michael
    Univ Hosp Mainz, Dept Anaesthesiol, Mainz, Germany.
    Aidoni, Zoi
    UGHT AHEPA, ICU, Athens, Greece.
    Aloizos, Stavros
    Army Share Fund Hosp, ICU, Athens, Greece.
    Tasioudis, Polychronis
    G Gennimatas Hosp Thessaloniki, ICU, Thessaloniki, Greece.
    Lampiri, Kleri
    Gen Hosp Kavala, ICU, Kavala, Greece.
    Zisopoulou, Vasiliki
    Gen Hosp Larissa, ICU1, Larisa, Greece.
    Ravani, Ifigenia
    Gen Hosp & Atras, ICU, Achaea, Greece.
    Pagaki, Eumorfia
    Gen Hosp Trikala Greece, ICU, Trikala, Greece.
    Antoniou, Angela
    Volos Gen Hosp, ICU, Volos, Greece.
    Katsoulas, Theodoros A.
    Ag Anargyroi Gen Hosp, ICU, Kifisia, Greece.
    Kounougeri, Aikaterini
    Konstantopoule Gen Hosp, ICU, Athens, Greece.
    Marinakis, George
    Korgialenio Benakio G Hosp Athens, ICU, Athens, Greece.
    Tsimpoukas, Fotios
    Lamia Gen Hosp, ICU, Lamia, Greece.
    Spyropoulou, Anastasia
    Panarkadian Gen Hosp Tripolis, ICU, Tripoli, Greece.
    Zygoulis, Paris
    Univ Hosp Larisa, Gen ICU, Thessaly, Greece.
    Kyparissi, Aikaterini
    HIPPOCRATEIO Gen Hosp Athens, ICU, Athens, Greece.
    Gupta, Manish
    Max Super Special Hosp, MICU, Vaishali, India.
    Gurjar, Mohan
    Sanjay Gandhi Postgrad Inst Med Sci, Dept Crit Care Med, Lucknow, Uttar Pradesh, India.
    Maji, Ismail M.
    St Johns Med Coll Hosp, MICU, Bangaluri, India.
    Hayes, Ivan
    Cork Univ Hosp, CUH GICU, Cork, Ireland.
    Kelly, Yvelynne
    St James Hosp, Gen ICU, Dublin, Ireland.
    Westbrook, Andrew
    St Vincents Univ Hosp, ICU, Dublin, Ireland.
    Fitzpatrick, Gerry
    Tallaght Hosp, Tallaght Intens Care, Dublin, Ireland.
    Maheshwari, Darshana
    Univ Hosp Galway, UHG ICU, Galway, Ireland.
    Motherway, Catherine
    Univ Hosp Limerick, ICU, Limerick, Ireland.
    Negri, Giovanni
    Osped G Fornaroli, ASST Ovest Milanese Presidio Magenta, Magenta, Italy.
    Spadaro, Savino
    Azienda Osped Univ St Anna, Units Terapia Intens Serv Anestesia, Ferrara, Italy.
    Nattino, Giuseppe
    ASST Lecco Osped A Manzoni, Rianimaz Gen, Lecce, Italy.
    Pedeferri, Matteo
    Presidio Osped S Leopoldo Mand, Rianimaz, AO Prov Lecco, Merate, Italy.
    Boscolo, Annalisa
    Azienda Osped Padova, Giustiniani I & II Istar, Padua, Italy.
    Rossi, Simona
    Azienda Osped G Salvini, Presidio Osped Rho, Serv Anestesia Rianimaz, Rhod, Italy.
    Calicchio, Giuseppe
    Azienda Osped Univ San Giovanni Dio & Ruggi Arago, Ctr Rianimaz, Salerno, Italy.
    Cubattoli, Lucia
    Azienda Osped Univ Senese, Rianimaz Gen, Siena, Italy.
    Di Lascio, Gabriella
    Azienda Osped Univ Careggi, Terapia Intens Emergenza, Florence, Italy.
    Barbagallo, Maria
    Azienda Osped Univ Parma, UO Anestesia Rianimaz Terapia Intens 2, Parma, Italy.
    Berruto, Francesco
    Osped E Agnelli, Rianimaz, Pinerolo, Italy.
    Codazzi, Daniela
    Fdn IRCCS Ist Nazl Tumori, Unita Terapia Intens, Milan, Italy.
    Bottazzi, Andrea
    Fdn IRCCS Policlin S Matteo, Rianimaz 2, Pavia, Italy.
    Fumagalli, Paolo
    Fdn Policlin San Matteo, Rianimaz 1, Pavia, Italy.
    Negro, Giancarlo
    Osped Francesco Ferrari, Anestesia & Rianimaz 1, Casarano, Italy.
    Lupi, Giuseppe
    Osped Maggiore, Serv Anestesia & Rianimaz, Cremona, Italy.
    Savelli, Flavia
    Osped Maurizio Bufalini, Anestesia & Rianimaz TI 2, Cesena, Italy.
    Vulcano, Giuseppe A.
    Osped Civile Nicola Giannettasio, Terapia Intens, Rossano, Italy.
    Fumagalli, Roberto
    Osped Niguarda Ca Granda, Anestesia & Rianimaz 1, Milan, Italy.
    Marudi, Andrea
    Nuovo Osped Civile St Agostino Estense, Rianimaz Neurorianimaz, Modena, Italy.
    Lefons, Ugo
    Osped Alta Val dElsa, Terapia Intens, Poggibonsi, Italy.
    Lembo, Rita
    Osped Castelli Verbania, Rianimaz Gen, Verbania, Italy.
    Babini, Maria
    Osped Civile Lugo, Serv Anestesia & Rianimaz, Lugo, Italy.
    Paggioro, Alessandra
    Osped Infermi Biella, ASL BI, Struttura Semplice Rianimaz & Terapia Intens, Biella, Italy.
    Parrini, Vieri
    Osped Mugello, Anestesia & Rianimaz, Borgo San Lorenzo, Italy.
    Zaccaria, Maria
    Osped Cirie, Rianimaz & Terapia Intens, Turin, Italy.
    Clementi, Stefano
    Osped Sesto San Giovanni, Terapia Intens Polivalente, Sesto San Giovanni, Italy.
    Gigliuto, Carmelo
    Azienda Osped Prov Pavia, Osped Vigevano, Rianimaz, Vigevano, Italy.
    Facondini, Francesca
    Osped Infermi, Reparto Rianimaz & Terapia Intens, Rimini, Italy.
    Pastorini, Simonetta
    Osped P Cosma AUSL 15 Alta Padovana, Serv Anestesia Rianimaz, Camposampiero, Italy.
    Munaron, Susanna
    Osped San Giacomo Augusta, Unita Terapia Intens, Castelfranco Veneto, Italy.
    Calamai, Italo
    Osped San Giuseppe, Rianimaz, Empoli, Italy.
    Bocchi, Anna
    Osped San Luca, Terapia Intens, Trecenta, Italy.
    Adorni, Adele
    Osped Valduce, Unita Terapia Intens Rianimatoria, Como, Italy.
    Bocci, Maria Grazia
    Policlin Agostino Gemelli, Ctr Rianimaz, Rome, Italy.
    Cortegiani, Andrea
    Univ Palermo, Unita Terapia Intens Polivalente, Policlin P Giaccone, Palermo, Italy.
    Casalicchio, Tiziana
    Osped San Giovanni Bosco, Terapia Intens, Turin, Italy.
    Mellea, Serena
    Osped Santa Maria Misericordia, Unita Terapia Intens, Perugia, Italy.
    Graziani, Elia
    Santa Maria Croci, Unita Operat Anestesia & Rianimaz, Ravenna, Italy.
    Barattini, Massimo
    Osped Santa Maria Nuova, Rianimaz, Florence, Italy.
    Brizio, Elisabetta
    Osped SS Annunziata, Serv Rianimaz, Taranto, Italy.
    Rossi, Maurizio
    Azienda Osped St Anna Como Presidio Menaggio, UO Anestesia & Rianimaz, Menaggio, Italy.
    Hahn, Michael
    Haugesund Hosp, ICU, Haugesund, Norway.
    Kemmerer, Nicolai
    Kongsberg Hosp, ICU, Kongsberg, Norway.
    Strietzel, Hans Frank
    Kristiansund Hosp, ICU, Kristiansand, Norway.
    Dybwik, Knut
    Nordlandssykehuset Bodo, ICU, Bodo, Norway.
    Legernaes, Terje
    Hamar Hosp, ICU, Hamar, Norway.
    Klepstad, Pal
    St Olavs Univ Hosp, Dept Intens Care Med, Trondheim, Norway.
    Olaussen, Even Braut
    Stavanger Univ Hosp, ICU, Stavanger, Norway.
    Olsen, Knut Inge
    Namsos Hosp, ICU, Namsos, Norway.
    Brresen, Ole Marius
    Telemark Hosp, ICU, Skien, Norway.
    Bjorsvik, Geir
    Univ Hosp Tromso, ICU, Tromso, Norway.
    Maini, Sameer
    Alesund Hosp, Med ICU, Alesund, Norway.
    Fehrle, Lutz
    Molde Hosp, ICU, Molde, Norway.
    Czuczwar, Miroslaw
    First Publ Teaching Hosp Lublin, ICU, Lublin, Poland.
    Krawczyk, Pawel
    Univ Hosp Krakow, ICU, Krakow, Poland.
    Zietkiewicz, Miroslaw
    John Paul II Hosp Krakow, Resp & Thorac Surg ICU, Krakow, Poland.
    Nowak, Lukasz R.
    Oncol Krakow Branch, Dept Anaesthesiol & Intens Care, Maria Sklodowska Curie Memo Rial Inst, Krakow, Poland.
    Kotfis, Katarzyna
    Pomeranian Med Univ, Dept Anaesthesia Intens Care & Acute Poisonin, Teaching Hosp 2, Szczecin, Poland.
    Cwyl, Katarzyna
    RCZ Lublin, ICU, Lublin, Poland.
    Gajdosz, Ryszard
    Scanmed St Raphael Hosp Krakow, Dept Anaesthesiol & Intens Care, Krakow, Poland.
    Biernawska, Jowita
    Pomeranian Med Univ, Dept Anaesthesiol & Intens Care, Teaching Hosp 1, Szczecin, Poland.
    Bohatyrewicz, Romuald
    Pomeranian Med Univ, Dept Anaesthesiol & Intens Care, Teaching Hosp 1, Szczecin, Poland.
    Gawda, Ryszard
    Univ Hosp Opole, Dept Anaesthesiol & Intens Care, Opole, Poland.
    Grudzien, Pawel
    Edward Szczekl Specialist Hosp Tarnow, ICU, Tarnow, Poland.
    Nasilowski, Pawel
    Gabriel Narutowicz Specialist Hosp Krakow, Dept Anaesthesiol & Intensive Care, Krakow, Poland.
    Popek, Natalia
    Stefan Zeromski Specialist Hosp Krakow, Dept Anaesthesiol & Intens Care, Krakow, Poland.
    Cyrankiewicz, Waldemar
    Antoni Jurasz Univ Hosp 1 Bydgoszcz, Dept Anaesthesiol & Intens Care, Bydgoszcz, Poland.
    Wawrzyniak, Katarzyna
    Antoni Jurasz Univ Hosp 1 Bydgoszcz, Dept Anaesthesiol & Intens Care, Bydgoszcz, Poland.
    Wnuk, Marek
    John Paul II Mem Hosp Belchatow, Dept Anaesthesiol & Intens Care, Belchatow, Poland.
    Maciejewski, Dariusz
    Prov Hosp Bielsko Biala, Dept Anaesthesiol & Intens Care, Bielsko Biala, Poland.
    Studzinska, Dorota
    St John Grande Hosp, Dept Anaesthesiol Ogy & Intens Care, Krakow, Poland.
    Zukowski, Maciej
    Pomeranian Med Univ, Dept Anaesthesiol Intens Care & Acute Poisoning, Teaching Hosp 2 Szczecin, Szczecin, Poland.
    Bernas, Szymon
    Dr Wladyslaw Bieganski Reg Specialist Hosp Lodz, Dept Anaesthesiol & Intens Therapy, Ctr Artificial Extracorporeal Kidney & Liver Supp, Lodz, Poland.
    Piechota, Mariusz
    Dr Wladyslaw Bieganski Reg Specialist Hosp Lodz, Dept Anaesthesiol & Intens Therapy, Ctr Artificial Extracorporeal Kidney & Liver Supp, Lodz, Poland;Ctr Artificial Extracorporeal Kidney & Liver Supp, Szczecin, Poland.
    Nowak, Ilona
    Univ Hosp Krakow, Dept Intens Care & Perioperat Med, Krakow, Poland.
    Fronczek, Jakub
    Univ Hosp Krakow, Dept Intens Care & Perioperat Med, Krakow, Poland.
    Serwa, Marta
    Med Univ Lodz, Univ Hosp, Lodz, Poland;Med Univ Lodz, Educ Ctr, Lodz, Poland.
    Machala, Waldemar
    Med Univ Lodz, Educ Ctr, Lodz, Poland;Med Univ Lodz, Dept Anaesthesiol & Intensive Care, Univ Hosp, Lodz, Poland.
    Stefaniak, Jan
    Univ Clin Ctr Gdansk, Dept Anaesthesiol & Intens Care, Gdansk, Poland.
    Wujtewicz, Maria
    Univ Clin Ctr Gdansk, Dept Anaesthesiol & Intens Care, Gdansk, Poland.
    Maciejewski, Pawel
    Orthoped Rehabil Univ Hosp Zakopane, Dept Anaesthesiol & Intens Care, Zakopane, Poland.
    Szymkowiak, Malgorzata
    Jozef Strus Hosp Poznan, Dept Anaesthesiol & Intens Care, Poznan, Poland.
    Adamik, Barbara
    Wroclaw Univ Hosp, Dept Anaesthesiol & Intens Care, Wroclaw, Poland.
    Catorze, Nuno
    CH Medio TEJO, UCIP, Tomar, Portugal.
    Branco, Miguel Castelo
    EPE, Ctr Hosp Cova Beira, Unidade Cuidados Intensivos, Covilha, Portugal.
    Barros, Ines
    Ctr Hosp Tondela Viseu, Unidade Cuidados Intensivos Polivalente, Viseu, Portugal.
    Barros, Nelson
    Ctr Hosp Tras os Montes & Alto Douro, Serv Med Intens, Vila Real, Portugal.
    Krystopchuk, Andriy
    Hosp Faro, Ctr Hosp Algarve, Intens Care & Emergency Dept, Faro, Portugal.
    Honrado, Teresa
    Hosp Sao Joao, Unidade Cuidados INtensivos Polivalente, Porto, Portugal.
    Sousa, Cristina
    Hosp Luz, UCI, Lisbon, Portugal.
    Munoz, Francisco
    Hosp SAMS, UMI, Lisbon, Portugal.
    Rebelo, Marta
    Hosp Egas Moniz, UCIP, Lisbon, Portugal.
    Gomes, Rui
    Hosp Garcia Orta, UCI, Almada, Portugal.
    Nunes, Jorge
    Hosp Lusiadas Lisboa, Unidade Cuidados Intensivos, Lisbon, Portugal.
    Dias, Celeste
    Hosp Lusiadas Lisboa, Unidade Cuidados Intensivos, Lisbon, Portugal.
    Fernandes, Ana Margarida
    Hosp S Jose CHLC EPE, UCI Neurocrit, Lisbon, Portugal.
    Petrisor, Cristina
    Clin Emergency Cty Hosp Cluj, Anaesthesia & Intensive Care 1, Cluj Napoca, Portugal.
    Constantin, Bodolea
    Municipal Hosp, ATI, Viana Do castelo, Portugal.
    Belskiy, Vladislav
    Privolzhskiy Dist Med Ctr, Dept Anesthesiol & Intens Care, Moscow, Russia.
    Boskholov, Boris
    Zhadkevich Clin Hosp, Dept Intens Care, Moscow, Russia.
    Rodriguez, Enver
    Gen Univ Castellon, UCI, Castellon De La Plana, Spain.
    Rebollo, Sergio
    HGU Santa Lucia, ICU, Murcia, Spain.
    Aguilar, Gerardo
    Hosp Clin Univ Valencia, Unidad Reanimac, Surg ICU, Valencia, Spain.
    Masdeu, Gaspar
    Hosp Tortosa Verge Cinta, Servei Med Intens, Tortosa, Spain.
    Irazabal Jaimes, Marian
    Hosp Gen Cataluna, Crit Care Unit, Barcelona, Spain.
    Prado Mira, Angela
    Hosp Gen Univ Albacete, Med Intens, Albacete, Spain.
    Bodi, Maria A.
    Hosp Univ Tarragona Joan XXIII, Gen ICU, Tarragona, Spain.
    Barea Mendoza, Jesus A.
    Hosp Univ 12 Octubre, Serv Med Intens, Madrid, Spain.
    Lopez-Cuenca, Sonia
    Hosp Univ Getafe, Serv Med Intens & Grandes Quemados, Getafe, Spain.
    Homez Guzman, Marcela
    Hosp Univ Henares, ICU, Coslada, Spain.
    Rico-Feijoo, Jesus
    Hosp Univ Rio Hortega Valladolid, Postoperat Crit Care Unit & Reanimat, Valladolid, Spain.
    Ibarz, Mercedes
    Hosp Univ Sagrad Corazon, ICU Hosp Univ Sagrad Corazon, Barcelona, Spain.
    Trenado Alvarez, Josep
    Hosp Univ Mutua Terassa, Intens Care Dept, UCI Semicrit, Terassa, Spain.
    Kawati, Rafael
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Sivik, Joakim
    Alingsas Lasarett, IVA Alingsas Lasarett, Alingsas, Sweden.
    Nauska, Jessica
    Blekingesjukhuset Karlskrona, Intensivvardsavdelning 31, Karlskrona, Sweden.
    Smole, Daniel
    Centralsjukhuset & Karlstad, IVA, Karlstad, Sweden.
    Parenmark, Fredric
    Gavle Sjukhus, IVA, Galve, Sweden.
    Lyren, Johanna
    Hudiksvalls Sjukhus, Intensivvardsavdelning, Gavleborg, Sweden.
    Rockstroh, Katalin
    Kalmar Lanssjukhus, IVA, Kalmar, Sweden.
    Ryden, Sara
    Karolinska Univ Hosp Huddinge, Karolinska ICU Huddinge, Huddinge, Sweden.
    Spangfors, Martin
    Intensiven, Kristianstad, Sweden.
    Strinnholm, Morten
    Kungalvs Hosp, ICU Kungalvs Hosp, Kungalv, Sweden.
    Walther, Sten
    Linkoping Univ Hosp, Cardiothorac ICU, Linkoping, Sweden.
    De Geer, Lina
    Linkoping Univ Hosp, ICU, Linkoping, Sweden.
    Nordlund, Peter
    Lanssjukhuset Ryhov, OP IVA Kliniken, Jonkoping, Sweden.
    Palsson, Staffan
    Intensivvardsavdelningen, Norrtalje, Sweden.
    Zetterquist, Harald
    Nykopings Lasarett, IVA, Nykoping, Sweden.
    Nilsson, Annika
    Ornskoldsviks Hosp, Ornskoldsv, IVA, Ornskoldsvik, Sweden.
    Thiringer, Karin
    Sahlgrenska Univ Hosp Molndal, IVA, Avdelning 227, Gothenburg, Sweden.
    Jungner, Marten
    Skane Univ Hosp, ICU SUS Malmo, Lund, Sweden.
    Bark, Bjorn
    Skane Univ Hosp, IVA Lund, Lund, Sweden.
    Nordling, Berit
    IVA Sundsvall, Sundsvall, Sweden.
    Skold, Hans
    Torsby Sjukhus, ICU, Torsby, Sweden.
    Brorsson, Camilla
    Univ Hosp Northern Sweden, CIP, Umea, Sweden.
    Persson, Stefan
    Univ Hosp Orebro, Intensivvarsdavdelningen USO, Orebro, Sweden.
    Bergstrom, Anna
    Vrinnevi Hosp, IVA Vrinnevisjukhuset, Norrkoping, Sweden.
    Berkius, Johan
    Vastervikssjukhus, IVA Vastervikssjukhus, Vastervik, Sweden.
    Holmstrom, Johanna
    Vastmanlands Sjukhus, Intensivvardsavdelningen Vasteras, Vasteras, Sweden.
    van Dijk, I
    Alrijne Ziekenhuis, Intens Care, Leiderdorp, Netherlands.
    van Lelyveld-Haas, L. E. M.
    Diakonessenhuis Utrecht, Intens Care, Utrecht, Netherlands.
    Ramnarain, D.
    Elisabeth Tweesteden Hosp Tilburg, Intens Care, Tilburg, Netherlands.
    Jansen, Tim
    HagaZiekenhuis, Intens Care, The Hague, Netherlands.
    Nooteboom, Fleur
    Laurentius Ziekenhuis, IC LZR, Roermond, Netherlands.
    van der Voort, Peter H. J.
    OLVG, ICU OLVG, Amsterdam, Netherlands.
    de Lange, Dylan
    UMC Utrecht, Dept Intens Care Med, Utrecht, Netherlands.
    Dieperink, Willem
    Univ Med Ctr Groningen, Dept Crit Care, Groningen, Netherlands.
    de Waard, Monique C.
    VU Univ Med Ctr Amsterdam, Intens Care Adults, Amsterdam, Netherlands.
    de Smet, Annemarie G. E.
    Univ Groningen, Univ Med Ctr, Intens Care Unit, Groningen, Netherlands.
    Bormans, Laura
    Zuyderland Med Centrer, Intens Care, Heerlen, Netherlands.
    Dormans, Tom
    Zuyderland Med Centrer, Intens Care, Heerlen, Netherlands.
    Dempsey, Ged
    Aintree Univ Hosp NHS Fdn Trust, Crit Care Unit, Liverpool, Merseyside, England.
    Mathew, Shiju J.
    Alexandra Hosp, ICU, Harlow, Essex, England.
    Raj, Ashok S.
    Batts Hlth NHS Trust, Whipps Cross Hosp, ICU, London, England.
    Grecu, Irina
    Basingstoke & North Hampshire Hosp, ITU HDU, Basingstoke, Hants, England;Royal Hampshire Cty Hosp, ICU, Winchester, Hants, England.
    Cupitt, Jason
    Blackpool Teaching Hosp NHS Fdn Trust, Crit Care Unit, Basingstoke, Hants, England.
    Lawton, Tom
    Bradford Royal Infirm, Crit Care Unit, Bradford, W Yorkshire, England.
    Clark, Richard
    Cent Manchester Fdn Trust, ICU, Manchester, Lancs, England.
    Popescu, Monica
    Chelsea & Westminster Fdn Trust, West Middlesex Univ Hosp, ICU, London, England.
    Spittle, Nick
    Chesterfield Royal Hosp, ICU, Calow, England.
    Faulkner, Maria
    Countess Chester Hosp NHS Fdn Trust, ICU, Chester, Cheshire, England.
    Cowton, Amanda
    Darlington Mem Hosp CDDFT, ICU, Darlington, Durham, England;Univ Hospl North Durham, ICU, Durham, England.
    Elloway, Esme
    Derriford Hosp, ICU, Plymouth, Devon, England.
    Williams, Patricia
    Dorset Cty Hosp, Crit Care Unit, Dorchester, England.
    Reay, Michael
    Russells Hall Hosp, Dudley Grp Hosp NHSFT, Dudley, England.
    Chukkambotla, Srikanth
    East Lancashire Hosp NHS Trust, Crit Care Unit, Burnley, Lancs, England.
    Kumar, Ravi
    East Surrey Hosp, CCU, Redhill, Surrey, England.
    Al-Subaie, Nawaf
    Espsom & St Helier Univ Hosp, ICU, Epsom, Surrey, England.
    Kent, Linda
    Fairfield Hosp, Crit Care Unit, Bury St Edmunds, Suffolk, England;Royal Oldham Hosp, ICU, Oldham, England.
    Tamm, Tiina
    Wexham Pk Hosp, Frimley Hlth, ICU, Slough, Berks, England.
    Kajtor, Istvan
    Frimley Pk Hosp, ICU, Frimley, England.
    Burns, Karen
    Furness Gen, ICU, Barrow In Furness, England.
    Pugh, Richard
    Glan Clwyd Gen Hosp, Crit Care Unit, Bodelwyddan, Wales.
    Ostermann, Marlies
    Guys & St Thomas Hosp, ICU, London, England.
    Kam, Elisa
    Hillingdon Hosp, ICU, Uxbridge, Middx, England.
    Bowyer, Helen
    Hinchingbrooke Healthcare NHS Trust, Crit Care Ctr, Huntingdon, England.
    Smith, Neil
    Hull Royal Infirm, HICU 1&2, Kingston Upon Hull, N Humberside, England.
    Templeton, Maie
    Imperial Coll Healthcare NHS Trust, Crit Care UNIT, London, England.
    Henning, Jeremy
    James Cook Univeristy Hosp, ICU 2 & 3, Middlesbrough, Cleveland, England.
    Goffin, Kelly
    James Paget Univ Hosp, ICU, Great Yarmouth, England.
    Kapoor, Ritoo
    Kent & Canterbury Hosp, K&C ITU, Canterbury, Kent, England.
    Laha, Shondipon
    Lancashire Leaching Hosp NHS Fdn Trust, CrCU, Preston, Lancs, England.
    Chilton, Phil
    Leighton Hosp, Crit Care Unit, Crewe, England.
    Khaliq, Waqas
    Lewisham & Greenwich NHS Trust, ITU HDU, London, England.
    Crayford, Alison
    ITU HDU, Maidstone, Kent, England.
    Coetzee, Samantha
    Medway NHS Fdn Trust, ICU, Gillingham, England.
    Tait, Moira
    Adult ICU, Musgrove Pk, Taunton, Somerset, England.
    Stoker, Wendy
    Northumbria Specialist Emergency Care Hosp, ICU, Cramlington, England.
    Gimenez, Marc
    Papworth Hosp NHS Fdn Trust, ICU, Cambridge, England.
    Pope, Alan
    Peterborough City Hosp, Crit Care Unit, Peterborough, Cambs, England.
    Camsooksai, Julie
    Poole Hosp NHS Trust, Crit Care Unit, Poole, Dorset, England.
    Pogson, David
    Queen Alexandra Hosp Portsmouth, Dept Crit Care, Portsmouth, Hants, England.
    Quigley, Kate
    Queen Elizabeth Hosp, ICU, Birmingham, W Midlands, England.
    Ritzema, Jenny
    Queen Elizabeth Hosp, Crit Care Dept, Gateshead, England.
    Hormis, Anil
    Rotherham NHS Fdn Trust, Crit Care Unit, Rotherham, S Yorkshire, England.
    Boulanger, Carole
    Royal Devon & Exeter NHS Fdn Trust, ICU, Exeter, Devon, England.
    Balasubramaniam, M.
    Royal Bolton NHS Hosp Trust, ICU & HCU, Farnworth, England.
    Vamplew, Luke
    Royal Bournemouth Hosp, Crit Care Unit, Bournemouth, Dorset, England.
    Burt, Karen
    Royal Cornwall Hosp NHS Trust, Crit Care Unit, Truro, England.
    Martin, Daniel
    Royal Free London NHS Fdn Trust, ICU, London, England.
    Craig, Jayne
    Royal Lancaster Infirm, ICU, Lancaster, England.
    Prowle, John
    Royal London Hosp, Adult Crit Care Unit, London, England.
    Doyle, Nanci
    Royal Surrey Cty Hosp, ICU, Guildford, Surrey, England.
    Shelton, Jonathon
    Royal Victoria Infirm, Ward 38 ICU, Newcastle Upon Tyne, Tyne & Wear, England.
    Scott, Carmen
    Royal Victoria Infirm, Ward 18 ICU, Newcastle Upon Tyne, Tyne & Wear, England.
    Donnison, Phil
    Salisbury Dist Hosp, ICU, Salisbury, Wilts, England.
    Shelton, Sarah
    Sherwood Forest Hosp NHS Fdn Trust, ICU, Sutton In Ashfield, England.
    Frey, Christian
    South Tyneside Dist Hosp, ITU HDU, South Shields, England.
    Ryan, Christine
    St George Hosp, GICU, London, England;St Georges Hosp NHS Trust London, Acute Dependency Unit, London, England.
    Spray, Dominic
    St George Hosp, Cardiothorac ICU, London, England.
    Barnes, Veronica
    St Georges Univ Hosp NHS Fdn Trust, Neuro ICU, London, England.
    Barnes, Kerry
    St Helier Hosp, ITU, Sutton, Surrey, England.
    Ridgway, Stephanie
    NHS Fdn Trust, Tameside Gen Hosp, Crit Care Unit, Ashton Under Lyne, England.
    Saha, Rajnish
    Princess Alexandra NHS Hosp, Crit Care Unit, Harlow, Essex, England.
    Clark, Thomas
    Torbay Hosp, ICU, Torquay, England.
    Wood, James
    Tunbridge Wells Hosp, ICU, Pembury, England.
    Bolger, Clare
    Univ Hosp Southampton NHS Fdn Trust, Gen Intens Care, Southampton, Hants, England.
    Bassford, Christopher
    Univ Hosp Coventry, Gen Crit Care, Coventry, W Midlands, England.
    Lewandowski, John
    Univ Hosp North Tees, Crit Care Unit, Stockton On Tees, England.
    Zhao, Xiaobei
    West Hertfortshire NHS Trust, Watford Gen Hosp, ICU, Level 6, Watford, England.
    Humphreys, Sally
    West Suffolk NHS Fdn Trust, Crit Care, Bury St Edmunds, Suffolk, England.
    Dowling, Susan
    Ward 4E Crit Care Unit, Whiston, England.
    Richardson, Neil
    William Harvey Hosp, ICU, Ashford, Kent, England.
    Burtenshaw, Andrew
    Worcestershire Royal Hosp, Crit Care Unit, Worcester, England.
    Stevenson, Carl
    Wye Valley NHS Trust, ICU, Hereford, England.
    Wilcock, Danielle
    York Teaching Hosp NHS Fdn Trust, Crit Care Unit, York, N Yorkshire, England.
    Nalapko, Yuiry
    Lugansk State Med Univ, Anaesthesia & Intens Care, Lugansk, Ukraine.
    A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention2019Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 52, s. 141-148Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.

    Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.

    Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).

    Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery. 

  • 4.
    Lipcsey, Miklos
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Chua, Horng-Ruey
    Schneider, Antoine G
    Robbins, Raymond
    Bellomo, Rinaldo
    Clinically manifest thromboembolic complications of femoral vein catheterization for continuous renal replacement therapy2014Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 29, nr 1, s. 18-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE:

    The safety of femoral vein (FV) catheterization for continuous renal replacement therapy is uncertain. We sought to determine the incidence of clinically manifest venous thromboembolism (VTE) in such patients.

    METHODS:

    We retrospectively studied patients with femoral high flow catheters (≥13F) (December 2005 to February 2011). Discharge diagnostic codes were independently screened for VTE. The incidence of VTE was also independently similarly assessed in a control cohort of patients ventilated for more than 2 days (January 2011 to December 2011) in the same intensive care unit (ICU).

    RESULTS:

    We studied 380 patients. Their mean age was 61 years, and 59% were male. The mean Acute Physiology and Chronic Health Evaluation III score was 84; average duration of continuous renal replacement therapy was 74 hours, and 232 patients (61%) survived to hospital discharge with an average length of hospital stay of 22 days. Only 5 patients (1.3%) had clinically manifest VTE after FV catheterization. In the control cohort of 514 ICU patients, the incidence of VTE was 4.4% (P < .05 compared with FV group).

    CONCLUSION:

    The incidence of clinically manifest VTE after FV catheterization with high flow catheters is low and lower to that seen in general ICU patients.

  • 5.
    Monge Garcia, Manuel Ignacio
    et al.
    Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain.
    Santos, Arnoldo
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. CIBER Enfermedades Resp CIBERES, Avd Monforte de Lemos 3-5,Pabellon 11,Planta 0, Madrid 28029, Spain.
    Diez Del Corral, Beatriz
    Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain.
    Guijo Gonzalez, Pedro
    Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain.
    Gracia Romero, Manuel
    Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain.
    Gil Cano, Anselmo
    Hosp SAS Jerez, Serv Cuidados Intens, C Circunvalac S-N, Jerez de la Frontera 11407, Spain.
    Cecconi, Maurizio
    St Georges Univ London, London SW17 0QT, England;St Georges Healthcare NHS Trust, Dept Intens Core Med, London SW17 0QT, England.
    Noradrenaline modifies arterial reflection phenomena and left ventricular efficiency in septic shock patients: A prospective observational study2018Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 47, s. 280-286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To determine whether noradrenaline alters the arterial pressure reflection phenomena in septic shock patients and the effects on left ventricular (LV) efficiency.

    Material and methods: Thirty-seven septic shock patients with a planned change in noradrenaline dose. Timing and magnitude (Reflection Magnitude and Augmentation Index) of arterial reflections were evaluated. Total, steady, and oscillatory LV power (also expressed as fraction of the total power), subendocardial viability ratio (SEVR), energy efficiency and transmission ratios were used as a marker of LV efficiency.

    Results: An incremental change in noradrenaline increased Reflection Magnitude [0.28(0.09) to 0.31(0.1], Augmentation Index [-6.4(23.6) to 4.8(20.7)%], and LV total power [0.79(IQR:0.47-1) to 0.98(IQR:0.57-127) W], all p < 0.001; whereas decreased arrival time of reflected waves [from 95(87 to 121) to 83(79 to 101)ms; p < 0.001]. Variables of LV performance showed a decreased efficiency: oscillatory fraction and energy efficiency ratio increased [20.9(5.7) to 22.8(4.9)%, and 82(1.7) to 10.1(2) mW.min.litre(-1); p < 0.001, respectively]; and energy transmission ratio and SEVR decreased [73.8(9.9) to 72(9.8)% and 146(IQR:113-188) to 143 (IQR:109-172)%, p = 0.003 and p = 0.041, respectively].

    Conclusions: Noradrenaline increased reflection phenomena, increasing LV workload and worsening LV performance in septic shock patients. These conditions could explain the detrimental effects during long-term use of noradrenaline.

  • 6.
    Parenmark, Fredric
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Gavle Cent Hosp, Dept Anaesthesia & Intens Care, Gavle, Sweden;Linkoping Univ, Fac Heath Sci, Dept Med & Heath Sci, Linkoping, Sweden.
    Karlstrom, Goran
    Swedish Intens Care Registry, Karlstad, Sweden.
    Nolin, Thomas
    Cent Hosp Kristianstad, Dept Anaesthesia & Intens Care, Kristianstad, Sweden.
    Fredrikson, Mats
    Linkoping Univ, Fac Med, Dept Clin & Expt Med, Div Occupat & Environm Med, Linkoping, Sweden;Linkoping Univ, Fac Med, Forum Ostergotland, Linkoping, Sweden.
    Walther, Sten M.
    Linkoping Univ, Fac Heath Sci, Dept Med & Heath Sci, Linkoping, Sweden;Linkoping Univ Hosp, Dept Cardiothorac Anaesthesia & Intens Care, Linkoping, Sweden.
    Reducing night-time discharge from intensive care. A nationwide improvement project with public display of ICU outcomes2019Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 49, s. 7-13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Discharge from an intensive care unit (ICU) during the night is an independent risk factor for adverse outcomes. A quality improvement project was conducted with the aim of reducing the incidence and the associated mortality after night-time discharge. Materials and methods: ICUs that submitted data to the Swedish Intensive Care Registry (SIR) agreed to appoint night-time discharge as a national quality indicator with detailed public display on the internet of various discharge proportions and outcomes. The registry was then examined for trends during a 10-year period with use of multilevel mixed-effects models. Results: We analysed 163,371 patients who were discharged alive from 70 ICUs to a general ward within the same hospital during 2006-2015. The prevalence of night-time discharge fell from 7.0% (95% CI: 52 to 8.7%) in 2006 to 4.9% (95% CI: 43 to 5.5%) in 2015 (P = .035 for trend). The original increased risk of death within 30 days after night-time discharge in 2006-2010, OR 1.20 (95% CI: 1.01 to 1.42), disappeared in 2011-2015, OR 1.06 (95% CI: 0.96 to 1.17). Conclusions: During the 10-year period of the quality improvement project, the annual prevalence and risk of death within 30-days after night-time discharge were reduced. The public display and feedback of audit data could have helped in achieving this.

  • 7.
    Ravn, Bo
    et al.
    Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 76 Stockholm, Sweden..
    Rimes-Stigare, Claire
    Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 76 Stockholm, Sweden..
    Bell, Max
    Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 76 Stockholm, Sweden..
    Hansson, Magnus
    Department of Laboratory Medicine (LABMED), H5, Division of Clinical Chemistry, C1 74 Karolinska Universitetssjukhuset Huddinge, 14186 Stockholm, Sweden..
    Hansson, Lars-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Martling, Claes-Roland
    Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 76 Stockholm, Sweden..
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Mårtensson, Johan
    Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 76 Stockholm, Sweden..
    Creatinine versus cystatin C based glomerular filtration rate in critically ill patients2019Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 52, s. 136-140Artikel i tidskrift (Refereegranskat)
  • 8.
    Sanner, Margareta A
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Two perspectives on organ donation: experiences of potential donor families and intensive care physicians of the same event.2007Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 22, nr 4, s. 296-304Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to explore how relatives and physicians understood cases where organ donation had been requested and what factors were salient for the decision on donation. Physicians of 25 deceased patients and 20 relatives were interviewed. The material was analyzed using qualitative methods. Eleven patients had declared their wishes on donation before death; in 14 cases the relatives had to decide. Half of these relatives accepted donation and half refused. The donation request was of secondary importance to the families; they were totally occupied by the death and initially tried to avoid the request by regarding "no" as a nonresponse. They needed support to relieve their immediate reactions of uneasiness, start rational thought processes, and reach well-grounded answers. The basis for requesting donation was good; relatives, with regard to circumstances, had been well prepared for the death by continuous information from the physicians and had confidence in staff, accepted that the question was raised, and understood the death criteria. However, about half the physicians experienced conflicts regarding prerequisites of procuring organs and dealing with relatives. Three different approaches were displayed: prodonation, neutral, and ambivalent. Only physicians with a prodonation approach received acceptance for donation.

  • 9. Schneider, Antoine G
    et al.
    Lipcsey, Miklós
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Bailey, Michael
    Pilcher, David V
    Bellomo, Rinaldo
    Simple translational equations to compare illness severity scores in intensive care trials2013Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 28, nr 5, s. 885.e1-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE:

    Comparison of illness severity for intensive care unit populations assessed according to different scoring systems should increase our ability to compare and meta-analyze past and future trials but is currently not possible. Accordingly, we aimed to establish a methodology to translate illness severity scores obtained from one system into another.

    MATERIALS AND METHODS:

    Using the Australian and New-Zealand intensive care adult patient database, we obtained simultaneous admission Acute Physiology and Chronic Health Evaluation (APACHE) II and APACHE III scores and Simplified Acute Physiology Score (SAPS) II in 634428 patients admitted to 153 units between 2001 and 2010. We applied linear regression analyses to create models enabling translation of one score into another. Sensitivity analyses were performed after removal of diagnostic categories excluded from the original APACHE database, after matching for similar risk of death, after splitting data according to country of origin (Australia or New Zealand) and after splitting admissions occurring before or after 2006.

    RESULTS:

    The translational models were APACHE III = 3.08 × APACHE II + 5.75; APACHE III = 1.47 × SAPS II + 8.6; and APACHE II = 0.36 × SAPS II + 4.4. The area under the receiver operating curve for mortality prediction was 0.853 (95% confidence interval, 0.851-0.855) for the "APACHE II derived APACHE III" score and 0.854 (0.852-0.855) for the "SAPS II derived APACHE III" vs 0.854 (0.852-0.855) for the original APACHE III score. Similarly, it was 0.841 (0.839-0.843) for the "SAPS II derived APACHE II score" vs 0.842 (0.840-0.843) for the original APACHE II score. Correlation coefficients as well as intercepts remained very similar in all subgroups analyses.

    CONCLUSIONS:

    Simple and robust translational formulas can be developed to allow clinicians to compare illness severity between studies involving critically ill patients. Further studies in other countries and health care systems are needed to confirm the generalizability of these results.

  • 10. Suzuki, Satoshi
    et al.
    Woinarski, Nicholas C. Z.
    Lipcsey, Miklós
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Candal, Cristina Lluch
    Schneider, Antoine G.
    Glassford, Neil J.
    Eastwood, Glenn M.
    Bellomo, Rinaldo
    Pulse pressure variation-guided fluid therapy after cardiac surgery: A pilot before-and-after trial2014Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 29, nr 6, s. 992-996Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this study is to study the feasibility, safety, and physiological effects of pulse pressure variation (PPV)-guided fluid therapy in patients after cardiac surgery. Materials and methods: We conducted a pilot prospective before-and-after study during mandatory ventilation after cardiac surgery in a tertiary intensive care unit. We introduced a protocol to deliver a fluid bolus for a PPV >= 13% for at least >10 minutes during the intervention period. Results: We studied 45 control patients and 53 intervention patients. During the intervention period, clinicians administered a fluid bolus on 79% of the defined PPV trigger episodes. Median total fluid intake was similar between 2 groups during mandatory ventilation (1297 mL[interquartile range 549-1968] vs 1481 mL [807-2563]; P =. 17) and the first 24 hours (3046 mL [interquartile range 2317-3982] vs 3017 mL [2192-4028]; P = .73). After adjusting for several baseline factors, PPV-guided fluid management significantly increased fluid intake during mandatory ventilation (P = .004) but not during the first 24 hours (P = .47). Pulse pressure variation-guided fluid therapy, however, did not significantly affect hemodynamic, renal, and metabolic variables. No serious adverse events were noted. Conclusions: Pulse pressure variation-guided fluid management was feasible and safe during mandatory ventilation after cardiac surgery. However, its advantages may be clinically small.

  • 11.
    Willebrand, Mimmie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden.
    Sjöberg, Folke
    Linkoping Univ, Dept Clin & Expt Med, S-58183 Linkoping, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden.
    Sveen, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Parents' perceived quality of pediatric burn care.2018Ingår i: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 43, s. 256-259Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To describe parents' perceived quality of pediatric burn care and evaluate factors associated with differences in perceived quality among parents.

    METHODS: 62 parents of children with burns were recruited on a Swedish national basis 0.8 to 5.6years after the child's injury. Measures were an adaptation of the Quality of Care Indices - Parent questionnaire consisting of 8 subscales and one overall question, the Impact of Event Scale -Revised, Montgomery Åsberg Depression Rating Scale, and Injury-specific fear-avoidance.

    RESULTS: Ratings of quality of care were high, especially regarding Staff Attitudes, Medical Treatment, and Caring Processes. Overall satisfaction rated from 1 to 10 was on average 9.1 (SD=1.2). Overall satisfaction and specific indices of Quality of care were not associated with burn severity, parent gender, or parent age. However, Quality of care was associated with current symptoms of posttraumatic stress and depression, and parents of girls expressed being less satisfied with Participation.

    CONCLUSIONS: Parents' perceived quality of care is associated with psychological health, but not with characteristics of the child's injury or age. The results suggest that burn care can improve by involving parents of girls more and by being more attentive towards parents who themselves appear stressed or worried.

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