Predictors of low cardiac output syndrome after combined mitral and tricuspid valve surgery.

Introduction: Low cardiac output syndrome (LCOS) is a common complication in cardiac surgery, and we evaluated the incidence of its early occurrence after mitral and tricuspid combined cardiac surgery and its associated risk factors.

Material And Method: Retrospective, single institution study. We included 88 consecutive adult patients with severe mitral insufficiency scheduled for elective mitral and tricuspid valve replacement surgery between January 2015 and November 2018.

Masseter muscle oxygen saturation is associated with central venous oxygen saturation in patients with severe sepsis.

Objective: This monocentric prospective study was conducted to determine if tissue oxygen saturation measured non invasively over masseter muscle site (Masseter-StO2) can predict the central venous oxygen saturation (ScvO2) level in severe sepsis and septic shock.

Methods: Sixteen consecutive patients with severe sepsis (n = 10) or septic shock (n = 6) were included in this study. ScvO2 was measured on blood samples taken from the superior vena cava via the distal line of a central venous catheter.

Predictive value of abdominal obesity vs. body mass index for determining risk of intensive care unit mortality.

Objective: To explore whether sagittal abdominal diameter as a marker of abdominal obesity is a risk factor for death and morbidity in patients in the intensive care unit and a better outcome determinant for obese patients than body mass index.

Design: Prospective, observational study from April 2008 to January 2009.

Setting: Two general intensive care units, both in Toulouse University Hospitals, France.

Population pharmacokinetics of ceftazidime in intensive care unit patients: influence of glomerular filtration rate, mechanical ventilation, and reason for admission.

The aim of this study was to develop a population-pharmacokinetic model of ceftazidime in intensive care unit patients to include the influence of patients' characteristics on the pharmacokinetics. Forty-nine patients for model building and 23 patients for validation were included in a randomized study. They received ceftazidime at 2 g three times a day or as 6 g per day continuously.

The importance of increased neck circumference to intubation difficulties in obese patients.

Background: Using the intubation difficulty scale (IDS), we sought to confirm that obese patients are more difficult to intubate than lean patients. We assessed classical bedside tests and included neck circumference.

Methods: We prospectively compared the incidence of difficult tracheal intubation in 70 obese [body mass index (BMI) > or = 30 kg/m(2)] and 61 lean patients (BMI < 30 kg/m(2)).

[Pathophysiology of septic shock].

Antigen presentation to inflammatory cells via pattern recognition receptors leads to the synthesis of NF-kappaB and other cytokine transcriptional factors. Leukocytes in the blood bind to endothelial receptors, the expression of which is mediated by proinflammatory cytokines via leukocyte integrins; the leukocytes then migrate to the site of inflammation. Endothelial procoagulant activity during sepsis is partly responsible for the disseminated intravascular coagulation (DIVC) and tissue hypoperfusion that follow.

Relative adrenal failure in the ICU: an identifiable problem requiring treatment.

Critically ill patients at some stage may develop adrenal insufficiency (AI). This article reviews the mechanisms, diagnosis criteria, consequences, and treatment of AI in various ICU conditions. Glucocorticoid insufficiency may be related to a decrease in glucocorticoid synthesis (ie, adrenal insufficiency) or to a reduced delivery of glucocorticoid to target tissues and cells.