| 1. |
- Akca, Ozan, et al.
(författare)
-
WHO Needs High FIO2?
- 2017
-
Ingår i: TURKISH JOURNAL OF ANAESTHESIOLOGY AND REANIMATION. - : AVES. - 2149-0937. ; 45:4, s. 181-192
-
Tidskriftsartikel (refereegranskat)abstract
- World Health Organization and the United States Center for Disease Control have recently recommended the use of 0.8 FIO2 in all adult surgical patients undergoing general anaesthesia, to prevent surgical site infections. This recommendation has arisen several discussions: As a matter of fact, there are numerous studies with different results about the effect of FIO2 on surgical site infection. Moreover, the clinical effects of FIO2 are not limited to infection control. We asked some prominent authors about their comments regarding the recent recommendations
|
|
| 2. |
- Cortegiani, Andrea, et al.
(författare)
-
Immunocompromised patients with acute respiratory distress syndrome : secondary analysis of the LUNG SAFE database.
- 2018
-
Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients.METHODS: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents.RESULTS: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio.CONCLUSIONS: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge.TRIAL REGISTRATION: ClinicalTrials.gov, NCT02010073 . Registered on 12 December 2013.
|
|
| 3. |
- Zacharowski, Kai, et al.
(författare)
-
Intensive care medicine in Europe : Perspectives from the European Society of Anaesthesiology and Intensive Care
- 2022
-
Ingår i: European Journal of Anaesthesiology. - 0265-0215. ; 39:10, s. 795-800
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Anaesthesiology represents a rapidly evolving medical specialty in global healthcare, currently covering advanced peri-operative, pre-hospital and in-hospital critical emergency management (CREM), intensive care medicine (ICM) and pain management. The aim of the European Society of Anaesthesiology and Intensive Care (ESAIC) is to develop and promote a coordinated interdisciplinary and multidisciplinary European network of Anaesthesiology and Intensive Care Medicine (AICM) societies for improvement of patient safety and outcome, and to enhance political and public awareness of the role of anaesthesiologists all over Europe. The ESAIC promotes coordinated interdisciplinary and multidisciplinary care for severely compromised patients, based on the European training requirements (ETR) within the European Union of Medical Specialists (UEMS).METHODSTo define the current situation of AICM in Europe, a survey was sent in April 2019 to the ESAIC Council and the ESAIC National Anaesthesiologists Societies Committee (NASC) members. The survey posed questions regarding the year of foundation, the inclusion of ICM in the society name, and if, and to what extent, various kinds (postoperative, general, specific, mixed) of national ICUs are being run by differing medical specialties. The study data were compiled and analysed by the ESAIC Board, Council and NASC in December 2019.RESULTS AND CONCLUSIONAmongst the 42 European national societies surveyed (41 members of ESAIC-NASC plus Luxembourg), nineteen (45%) also include terms related to critical care medicine or ICM in their names, seven (17%) include terms related to reanimation and three (7%) to resuscitation. In recent years, several national societies revised their names to better reflect their gradual embrace of peri-operative medicine, ICM, CREM and pain management. Approximately 70% of ICU beds in Europe, and 100% in Scandinavia, are being run by anaesthesiologists, the remaining 30% being managed by physicians from other surgical or medical specialties. To emphasise future needs and resources of European AICM, the ESAIC drafted an ICM roadmap in terms of clinical practice, organisation of healthcare, interprofessional and interdisciplinary collaboration, patient safety, outcome and empowerment, professional working conditions, and changes in research, teaching and training required to meet future challenges and expectations.
|
|
