Patients with hip fracture admitted to critical care: epidemiology, interventions and outcome.

Introduction: Although there is much current debate about the use of critical care to enhance peri-operative care of patients with hip fracture there are limited supporting data. We investigated the epidemiology, critical care interventions and outcomes of patients with hip fracture admitted to a large UK critical care unit.

Patients And Methods: We reviewed all patients with hip fracture (excluding those with multiple trauma, and those with femoral shaft or peri-prosthetic fracture) who were admitted to our critical care unit during a four year period.

Early lactate clearance in septic patients with elevated lactate levels admitted from the emergency department to intensive care: time to aim higher?

Purpose: Septic patients with hyperlactatemia have increased mortality rates, irrespective of hemodynamic and oxygen-derived variables. The aims of the study are the following: (1) to ascertain whether lactate clearance (LC) (percentage change in lactate over unit time) predicts mortality in septic patients admitted to intensive care directly from the emergency department and (2) to calculate the optimal "cut-off" value for mortality prediction.

Methods: Three-year retrospective observational study of consecutive patients with severe sepsis and septic shock admitted to intensive care from the emergency department of a tertiary UK hospital.

Reducing ventilator-associated pneumonia in intensive care: impact of implementing a care bundle.

Objectives: Ventilator-associated pneumonia is the most common intensive care unit-acquired infection. Although there is widespread consensus that evidenced-based interventions reduce the risk of ventilator-associated pneumonia, controversy has surrounded the importance of implementing them as a "bundle" of care. This study aimed to determine the effects of implementing such a bundle while controlling for potential confounding variables seen in similar studies.

C5a-mediated neutrophil dysfunction is RhoA-dependent and predicts infection in critically ill patients.

Critically ill patients are at heightened risk for nosocomial infections. The anaphylatoxin C5a impairs phagocytosis by neutrophils. However, the mechanisms by which this occurs and the relevance for acquisition of nosocomial infection remain undetermined.

Induction drug and outcome of patients admitted to the intensive care unit after emergency laparotomy.

Background And Objective: Etomidate is often used to induce anaesthesia in sick patients owing to its relative cardiovascular stability. However, etomidate affects adrenal cortical activity, and there is concern that this could impair outcome in patients undergoing emergency surgery.

Methods: We retrospectively analysed data from 176 patients admitted to an ICU after emergency laparotomy.