Carbon dioxide output in septic shock

Critical Care, Mar 2005

V Pilas, N Vucic, K Cala

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Carbon dioxide output in septic shock

0 M Sartzi, M Charitidou, A Panagiotakopoulou , C Michas, F Tsidemiadou , P Clouva-Molyvdas 'THRIASSIO' Hospital of Eleusis , Attica, Greece Critical Care 2005, 9(Suppl 1):P3 (DOI 10.1186/cc3066) 1 L Lorente , M Lecuona, J Villegas, M Mora , A Sierra Hospital Universitario de Canarias , Santa Cruz de Tenerife , Spain Critical Care 2005, 9(Suppl 1):P2 (DOI 10.1186/cc3065) 2 Y Bicer, S Simsek, N Yapici , O Aydin, F Sogut , Z Aykac Siyami Ersek Thoracic and Cardiovascular Surgery Center , Istanbul, Turkey Critical Care 2005, 9(Suppl 1):P10 (DOI 10.1186/cc3073) 3 Ulsan University Hospital , Ulsan , South Korea Critical Care 2005, 9(Suppl 1):P13 (DOI 10.1186/cc3076) 4 Asian Medical Center, University of Ulsan College of Medicine , Seoul , South Korea 5 Center of Laboratory Diagnostics of Diseases of Mother and Child , Yekaterinburg, Russia Critical Care 2005, 9(Suppl 1):P23 (DOI 10.1186/cc3086) 6 UMIST , Manchester , UK 7 Clinical Hospital N40 , Yekaterinburg , Russia 8 I Kano, T Kamohara, K Ikegami, H Taguchi, K Kawamura, J Yazawa, T Mouri Dokkyo University School of Medicine, Koshigaya Hospital , Koshigaya , Japan Critical Care 2005, 9(Suppl 1):P29 (DOI 10.1186/cc3092) 9 CHU Bicetre , Kremlin Bicetre, France Critical Care 2005, 9(Suppl 1):P52 (DOI 10.1186/cc3115) 10 Geneva University Hospital , Geneva , Switzerland 11 Centre Hopital General , Belfort , France 12 Medical School , Hannover, Germany Critical Care 2005, 9(Suppl 1):P393 (DOI 10.1186/cc3456) 13 Friedrich-Schiller-University , Jena , Germany 14 University of Colorado , Denver, CO, USA Critical Care 2005, 9(Suppl 1):P405 (DOI 10.1186/cc3468) 15 Denver Health Medical Center , Denver, CO , USA 16 Pneumonology Department, School of Medicine, University of Ioannina , Greece Critical Care 2005, 9(Suppl 1):P414 (DOI 10.1186/cc3477) 17 Red Cross Hospital of Athens , Greece Severe community-acquired pneumonia in the intensive care unit Introduction Community-acquired pneumonia remains a common condition worldwide. It is associated with significant morbidity and mortality. The aim of this study was to evaluate conditions that could predict a poor outcome. Design Retrospective analyse of 69 patients admitted to the ICU from 1996 to 2003. Demographic data included age, sex and medical history. Etiologic agents, multiorgan dysfunction, nosocomial infections, SAPS II and PORT scores were recorded for each patient. For statistical analysis we used a t test, chi-square test and Mann-Whitney U test on SPSS. A value of P less than 0.05 was considered significant. Results Forty-seven patients were male and 22 patients were female. Mean age was 52 years. Sixty-seven percent had serious pre-morbid conditions including pulmonary disease (34.8%), cardiac problems (36.2%), diabetes (13%) and chronic liver disease (5.8%); 40.6% were smokers, drug abusers or alcohol dependents. Sixtyeight patients required invasive mechanical ventilation. The average length of ventilation was 13.5 days, median 8 days. The mean SAPS II score was 40.14 and the mean PORT score was 141. The mortality rate was 27.5% (SAPS II estimated mortality, 35%). Complications reported were ARDS (40.6%), septic shock (34.8%), acute renal failure (2.9%), cardiac arrest (8.7%) and nosocomial infeccions (46.4%). Mortality rates were higher for previous hepatic (75%) and metabolic (33%) diseases. We found a close association between crude mortality and SAPS II score (P = 0.003) and development of complications (P = 0.0028). Respiratory dysfunction (P = 0.006) and septic shock (P = 0.022) were most significantly related to mortality. No significant differences were founded regarding age, comorbidities, PORT score, etiologic agents, nosocomial infections and length of invasive mechanical ventilation. Conclusions Previous hepatic chronic disease was strictly related to higher mortality as well as isolation of MRSA. ARDS and septic shock predicted a poor outcome. SAPS II score was the best severity indicator of mortality. - Closed endotracheal suction system without periodic change versus open endotracheal system Objective It is known that the closed tracheal suction system (CTSS) produces less hemodynamic and gasometric deterioration than an open tracheal suction system (OTSS). Use is limited because no decrease in the incidence of ventilator-associated pneumonia (VAP) was found and also because it is more expensive. But, is daily periodic change of the CTSS necessary? The aim of this study was to analyze the incidence of VAP using a CTSS without periodic change versus an OTSS. Methods It is a prospective study of ICU patients from 1 January 2004 to 31 October 2004. Patients who required mechanical ventilation (MV) were randomized into two groups: one group was suctioned with CTSS without periodic change and another group with OTSS. An aspirate tracheal swab and a throat swab on admission and afterwards twice weekly were taken. VAP was classified based on throat flora in endogenous and exogenous samples. The sta (...truncated)


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V Pilas, N Vucic, K Cala. Carbon dioxide output in septic shock, Critical Care, 2005, pp. P50, 9,