Abstract
Patient safety is one of the major concerns of healthcare professionals, especially in an intensive care setting. For identifying risk factors for adverse events and drug-related problems (DRPs), a clinical pharmacy (CP) service in the adult and pediatric ICUs of the Albert Einstein Jewish Hospital (HIAE) was created to work directly with medical prescriptions. This service, started in 2001, assesses factors such as: the route and frequency of administration, dose, compatibility, dilution, drug interaction, adverse drug reactions, allergy, infusion time, and indication. After the acceptance of a pharmacist in this team, in 2005, the clinical pharmacy has been expanded, with one pharmacist in each ICU, and in 2006 the clinical pharmacist has also started to act in procedures managed by the institution.
Highlights
Clinical evidence suggests that bacterial translocation (BT) may not be the primary cause in the development of sepsis and multiple organ dysfunction
In previous work we demonstrated that platelet-derived attributed to bacterial translocation (BT), and the aggravation of microparticles (MP) can induce endothelial and vascular smooth sepsis is related to the increased vascular permeability state that muscle cell apoptosis in septic patients through NADPH oxidase- potentates the BT index
The aim of this study is to evaluate the effects of hypertonic saline (HSS) 7.5% and lactated Ringer’s (LR) solutions on intestinal BT in rats that underwent intestinal obstruction and ischaemia (IO)
Summary
Clinical evidence suggests that bacterial translocation (BT) may not be the primary cause in the development of sepsis and multiple organ dysfunction. The evolution of intensive care and its results related to the survival of very critically ill patients produce a group of survivors characterized by complex co-morbidities and prolonged dependence on mechanical ventilation (more than 21 days). Methods A prospective, nonrandomized, observational and comparative study that compares effects on PPV of the VC with another three PC ventilatory settings applied in sedated and mechanically ventilated critically ill patients with an arterial catheter in place. The APACHE II score (26.1 ± 9.5 vs 17.7 ± 6.0, P = 0.000), mean SOFA score (10.55 ± 3.41 vs 3.52 ± 2.29, P < 0.001), use of a central catheter (87.5% vs 60.7%, P = 0.001), dialysis (21.4% vs 5.4%, P = 0.013), mechanical ventilation (91.1% vs 35.7%, P < 0.001) and presence of septic shock (32.1% vs 8.9%, P = 0.002) were associated with worse prognosis. Several complications are possible, making it necessary to provide an immediate, specialized, postoperatory intensive care treatment
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