Abstract

Cerebral autoregulation (CA) maintains cerebral blood flow over a range of perfusion pressure. Continuous CA monitoring might define pressure targets minimising secondary brain injury, but application is limited by available monitoring modalities. Near-infrared spectroscopy (NIRS) is a noninvasive optical technique characterising aspects of CA. The NIRS-derived tissue oxygenation index (TOI) is correlated with blood pressure (BP) to produce an index of vascular reactivity (TOx) [1]. The contribution from extracerebral tissues, optical complexity of injured brain and complex physiology represented by NIRS are likely to limit agreement with other techniques. NIRS-measured deoxyhaemoglobin (HHb) may have advantages as its physiological confounds are less complicated and are predominantly in the cerebral venous circulation. This study compares HHb with established indices of reactivity - the mean velocity index (Mx) and oxygen reactivity index (ORx).

Highlights

  • Sepsis is primarily a disease of the aged and 60% of sepsis occurs in patients older than 65 years, 80% of deaths due to sepsis occur in this age group

  • The purpose of the study is to elucidate the immunological changes that occur in Klotho mice after sepsis in order to identify therapeutic targets for sepsis that occurs in aged individuals

  • Forty-four septic patients and 48 gender-matched healthy volunteers were prospectively enrolled in the study, which included the following investigations: (1) The Sequential Organ Failure Assessment (SOFA) score and clinical outcome were compared between adult sepsis (

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Summary

Introduction

Sepsis is primarily a disease of the aged and 60% of sepsis occurs in patients older than 65 years, 80% of deaths due to sepsis occur in this age group. The aim of this study was to determine the reasons behind out-of-hours discharges in our hospital and the effect this has on mortality This audit reviewed the discharge process of patients from an adult general ICU to the general wards before and after the introduction of a liaison nurse post over a 3-year, 3-month time period. The aim of this study was to establish and compare the quality and value of the summaries as judged by ICU doctors and GPs. The relationship between provider volume and patient outcome has been demonstrated for many medical and surgical services, including critical care. Methods In this single-centre observational study we aimed to quantify functional dependency at three different time points: discharge from ICU (DI), discharge from hospital (DH) and discharge from nursing home rehabilitation unit (DR) To this end we retrospectively assed Barthel scores (BS) for individual patients [1], with a duration of mechanical ventilation >48 hours.

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