92 research outputs found

    The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

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    Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

    Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

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    Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

    EXPERIMENTAL RESULTS ON A NEW O–2 CENTER IN CaF2 CRYSTALS

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    Ce travail donne le modèle d'un centre O–2 perturbé observé dans des fluorines naturelles. Ce modèle a été déduit des expériences d'absorption optique, d'effet Raman et des mesures RPE et ENDOR. Une bande d'absorption optique de ce centre est observée dans le visible. Elle présente une structure vibronique permettant de déterminer l'énergie de vibration interne du O–2 dans son état électronique excité. Le quantum d'énergie est de 900 ± 30 cm-1. L'énergie de vibration de l'état fondamental a été déterminée à partir des mesures Raman. Son quantum est de 1 038 ± 2 cm-1.The model of a perturbed O–2 center in CaF2 is discussed on the basis of results from optical absorption, resonant Raman scattering, EPR and ENDOR measurements. Compared to the unperturbed center [4] the optical absorption of the presently discussed one is shifted to the visible and it exhibits a multiphonon structure. The O–2 stretching mode energy in the electronic excited state deduced from this structure is found to be 900 cm-1. A resonant Raman effect is observed up to 2nd order yielding the vibrational energy in the electronic ground state. The determined value amounts to 1 038 cm-1. The Raman selection rules are consistent with a molecular vibration along [l, 0, 0]. The ENDOR data are coherent when the center is assumed to be located near a fluorine cube edge probably substituting for two F- ions. At room temperature the center exhibits an orthorhombic g tensor in EPR. At higher temperatures, however, motional effects show up. The EPR spectrum becomes axial indicating vibrational motion of the center

    Thermische Erholung UV-bestrahlter AgCl-Einkristalle

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    Moment analysis of the R2 zero-phonon line in NaF under uniaxial stress

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