tailieunhanh - Báo cáo y học: " Year in review 2006: Critical Care - cardiology"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Year in review 2006: Critical Care - cardiology. | Available online http content 11 4 225 Review Year in review 2006 Critical Care - cardiology Nawaf Al-Subaie and David Bennett General Intensive Care Unit St George s Hospital Blackshaw Road London SW17 0QT UK Corresponding author Nawaf Al-Subaie nalsubaie@ Published 24 August 2007 This article is online at http content 11 4 225 2007 BioMed Central Ltd Critical Care 2007 11 225 doi cc5978 Abstract This review summarizes key research papers published in the fields of cardiology and intensive care during 2006 in Critical Care and where relevant in other journals within the field. The papers have been grouped into categories haemodynamic monitoring vascular access in intensive care microvascular assessment and manipulation and impact of metabolic acidosis on outcome. Haemodynamic monitoring Successful use of central venous oxygen saturation Scvc2 in the management of early sepsis 1 has led to interest in the use of this variable in high-risk patients who are undergoing major surgery in whom the concept of goal-directed therapy is well established 2-4 . The collaborative study group on perioperative Scvc2 monitoring has conducted a multicentre pilot study to assess the incidence of low Scvc2 in high-risk surgical patients and its impact on outcome in terms of postoperative complications. Takala and coworkers 5 included all patients satisfying two or more of the criteria proposed by Shoemaker and coworkers 2 who were undergoing major surgery defined as an intra-abdominal or retroperitoneal procedure with an expected duration of at least 90 min. In the 60 patients studied low perioperative Scvc2 was associated with a greater risk for complications with a mean value of 73 for discriminating between patients who did and those who did not develop complications 72 sensitivity and 61 specificity . This is in close agreement with values observed in healthy volunteers 6 and more importantly with the 8-hour postoperative mean Scvc2 of 75