Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study.

Objectives: To explore variables associated with adverse maternal/fetal/neonatal outcomes among pregnant/postpartum patients admitted to ICU for hypertensive disorders of pregnancy (HDP).

Methods: Multicenter, prospective, national cohort study.

Results: Variables independently associated with maternal/fetal/neonatal mortality among 172 patients were as follows: Acute Physiology and Chronic Health Evaluation-II (APACHE-II)(OR1.

Effects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers.

Purpose: To characterize the microvascular effects of a brief period of hyperoxia, in patients with septic shock and in healthy volunteers.

Materials And Methods: In 20 patients with septic shock, we assessed systemic hemodynamics, sublingual microcirculation by SDF-videomicroscopy, and skin perfusion by capillary refill time (CRT), central-peripheral temperature (ΔT°), and perfusion index. Measurements were performed at baseline and after 5 min of inspired oxygen fraction of 1.

Poor agreement in the calculation of venoarterial PCO to arteriovenous O content difference ratio using central and mixed venous blood samples in septic patients.

Purpose: Central venous minus arterial PCO to arterial minus central venous O content difference ratio (PCO/CO) has been proposed as a clinical surrogate for respiratory quotient. Our goal was to assess its interchangeability with mixed venous minus arterial PCO to arterial minus mixed venous O content difference ratio (PCO/CO).

Materials And Methods: This is a subanalysis of a previously published study.

Relationship of at Admission Lactate, Unmeasured Anions, and Chloride to the Outcome of Critically Ill Patients.

Objectives: To investigate the association between the concentration of the causative anions responsible for the main types of metabolic acidosis and the outcome.

Design: Prospective observational study.

Setting: Teaching ICU.

Prognostic value of ventricular diastolic dysfunction in patients with severe sepsis and septic shock.

Objectives: To evaluate the prevalence of myocardial dysfunction and its prognostic value in patients with severe sepsis and septic shock.

Methods: Adult septic patients admitted to an intensive care unit were prospectively studied using transthoracic echocardiography within the first 48 hours after admission and thereafter on the 7th-10th days. Echocardiographic variables of biventricular function, including the E/e' ratio, were compared between survivors and non-survivors.

Similar Microcirculatory Alterations in Patients with Normodynamic and Hyperdynamic Septic Shock.

Rationale: In normodynamic septic shock, the quantitative assessment of sublingual microcirculation has shown decreases in perfused vascular density and red blood cell velocity. However, no studies have been performed in hyperdynamic septic shock.

Objectives: To characterize the microcirculatory patterns and rule out the presence of fast red blood cell velocity in patients with hyperdynamic septic shock.

Dissociation between sublingual and gut microcirculation in the response to a fluid challenge in postoperative patients with abdominal sepsis.

Background: This study was performed to compare intestinal and sublingual microcirculation and their response to a fluid challenge.

Methods: Twenty-two septic patients in the first postoperative day of an intestinal surgery, in which an ostomy had been constructed, were evaluated both before and 20 min after a challenge of 10 mL/kg of 6% hydroxyethylstarch 130/0.4.

[Augmented renal clearance in critically ill patients: incidence, associated factors and effects on vancomycin treatment].

Objective: An augmented renal clearance has been described in some groups of critically ill patients, and it might induce sub-optimal concentrations of drugs eliminated by glomerular filtration, mainly antibiotics. Studies on its occurrence and determinants are lacking. Our goals were to determine the incidence and associated factors of augmented renal clearance and the effects on vancomycin concentrations and dosing in a series of intensive care unit patients.

Urinary strong ion difference is a major determinant of plasma chloride concentration changes in postoperative patients.

Objective: To show that alterations in the plasma chloride concentration ([Cl-]plasma) during the postoperative period are largely dependent on the urinary strong ion difference ([SID]urine=[Na+]urine+[K+]urine-[Cl-]urine) and not on differences in fluid therapy.

Methods: Measurements were performed at intensive care unit admission and 24 hours later in a total of 148 postoperative patients. Patients were assigned into one of three groups according to the change in [Cl-]plasma at the 24 hours time point: increased [Cl-]plasma (n=39), decreased [Cl-]plasma (n=56) or unchanged [Cl-]plasma (n=53).

Systemic and microcirculatory effects of dobutamine in patients with septic shock.

Purpose: The aim of this study was to characterize the cardiovascular responses to dobutamine and their predictors. Our hypotheses were that dobutamine mainly produces tachycardia and vasodilation and fails to improve the microcirculation of patients with septic shock.

Materials And Methods: Systemic hemodynamics and sublingual microcirculation were evaluated with dobutamine (0, 2.

Clinical characteristics and outcomes of obstetric patients admitted to the intensive care unit.

Objective: To identify the reasons for admitting pregnant women to intensive care units (ICUs) in Buenos Aires, Argentina.

Methods: The admission diagnoses of pregnant women hospitalized over 2 years at 4 ICUs were retrospectively studied.

Results: During the studied period, 242 (3.

Quantitative assessment of the microcirculation in healthy volunteers and in patients with septic shock.

Objective: The microcirculation of septic patients has been characterized only semiquantitatively. Our goal was to characterize the sublingual microcirculation in healthy volunteers and patients with septic shock quantitatively. Our hypotheses were that 1) hyperdynamic blood flow is absent in septic shock; 2) nonsurvivors show more severe alterations than survivors; and 3) quantitative and semiquantitative microcirculatory parameters have a similar performance.

Fluids in the postoperative period: effects of lack of adjustment to body weight.

Objective: To compare the differences in fluid and electrolyte balance in patients with low and high weight in the first postoperative day.

Methods: Over a period of 18 months, we prospectively evaluated 150 patients in the first 24 hours after surgery, in a university-affiliated hospital intensive care unit. Patients with low weight (< 60 kg) and high body weight (> 90 Kg) were compared in terms of fluid intake and output.