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21. |
Glomerular permeability after surgical trauma in children: Relationship between microalbuminuria and surgical stress score |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1626-1629
Armando Sarti,
A. Raffaele De Gaudio,
Antonio Messineo,
Alessandro Ventura,
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摘要:
ObjectivesTo determine whether there is an increase of urinary albumin during and after surgical trauma and investigate a possible relationship between microalbuminuria and the severity of surgical stress.DesignProspective study.SettingUniversity hospital pediatric intensive care unit.PatientsForty consecutive children scheduled for elective surgery.InterventionsNone.Measurements and Main ResultsMicroalbuminuria/urinary creatinine ratio (MACR) was measured before, during, and after elective moderate or major surgical procedures. The Oxford Surgical Stress Score (SSS) was determined for each patient at the end of the operation, and its relationship with maximum deviation of MACR from baseline values was investigated. MACR showed a progressive increase during surgery and a decrease afterward, reaching preoperative values in most cases within 24 hrs after the end of surgery. There was a significant correlation between the increase in MACR and severity of the surgical trauma as measured by SSS. Two patients showed a rise in MACR after the initial postoperative normalization before clinical appearance of a surgical complication and one patient showed a persistent rise in MACR before clinical appearance of a septic complication. None of the other patients showed any rise in MACR after postoperative normalization, and they all had an uneventful recovery.ConclusionsMACR rises during and after major or moderate elective surgery in children. There is a significant positive correlation between severity of surgical trauma and capillary permeability in pediatric patients. Microalbuminuria, as an index of capillary permeability, may be an early sign of incipient complications and assist in the identification of those patients whose condition will deteriorate. The test is a cheap, blood-sparing, easy-to-perform bedside procedure that may have a useful role in clinical practice for evaluating the effect of surgical trauma on capillary permeability in children.
ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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22. |
Credentialing for critical care in small hospitals |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1630-1632
David Powner,
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摘要:
ObjectiveTo assess credentialing practices for critical care admissions and procedures in smaller hospitals within the United States.MethodsA questionnaire was sent to credentialing coordinators of 500 randomly selected American Hospital Association hospitals with fewer than 300 beds.Measurements and Main ResultsMost hospitals validate qualifications for intensive care unit (ICU) admitting and procedural privileges through recommendations only. Fewer (16%) require a specified prior number of procedures to have been performed, and 9% require prospective supervision before privileges are granted. Critical care subspecialists are present in 57% of these hospitals and tend to be in the larger facilities with more critical care beds. Criteria for ICU admission and procedure privileges appear to be inclusive, because family medicine, obstetrics-gynecology, orthopedic surgery, and neurology specialists are often credentialed. The presence of a critical care subspecialist is associated with fewer hospitals credentialing family medicine specialists for ICU admission and procedures but not obstetrician-gynecologists, orthopedic surgeons, or neurologists.ConclusionsThis is a brief descriptive report of hospital policies that define which physicians are permitted to care for critically ill/injured patients in small U.S. hospitals. The presence of a critical care specialist appears to influence only slightly the ICU credentialing processes for other selected specialists.
ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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23. |
Enteral nutrition: How do we get more of the good and less of the bad and ugly? |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1633-1634
Per Thorborg,
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ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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24. |
Assessment of intravascular volume: A comedy of errors |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1635-1636
Paul Marik,
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ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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25. |
Gut protection: Why and how? |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1637-1638
Todd Morris,
David Dries,
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ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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26. |
Low-dose dopamine in the intensive care unit: DNR or DN℞? |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1638-1639
Maria Rudis,
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ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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27. |
Living, not existing, beyond critical care |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1640-1641
Mihae Yu,
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ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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28. |
Acute cor pulmonale in acute respiratory distress syndrome: A dreaded complication of the past? |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1641-1642
Marielle Scherrer-Crosbie,
Scott Streckenbach,
Warren Zapol,
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ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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29. |
Serum cytokines, proteins, and receptors in acute pancreatitis: Mediators, markers, or more of the same? |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1642-1644
Pamela Lipsett,
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ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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30. |
Caution: Use fat emulsions judiciously in intensive care patients |
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Critical Care Medicine,
Volume 29,
Issue 8,
2001,
Page 1644-1645
Frederick Moore,
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ISSN:0090-3493
出版商:OVID
年代:2001
数据来源: OVID
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