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Biomedical subjects

R Tufano

Publications and source records attributed to R Tufano.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Candidemia in Intensive Care patients. Risk factors and mortality.

AIM: Aim of this study was to evaluate if the risk factors for candidemia could be used to identify patients who have a greater possibility of death after Candida spp blood infection. METHODS: A retrospective observational comparative study. SETTING: the Intensive Care Unit of an University Hospital. PATIENTS: 478 critical patients were included in this study. Neutropenic and immuno-suppressed patients were excluded. INTERVENTIONS: routine care for acutely ill patients, with regard to their pathology. MEASUREMENTS: age, APACHE II at the admission, length of stay in the ICU before the diagnosis of candidemia and whole length of stay, outcome, risk factors for candidemia (Candida colonisation, previous antibiotic therapy, central vein, mechanical ventilation, abdominal surgery, hemodialysis, adult respiratory distress syndrome, chronic obstructive pulmonary disease, diabetes, malignancy, splenectomy, immunosuppression, total parenteral nutrition, malnutrition) and clinical signs of multiorgan failure, systemic inflammatory response syndrome, sepsis or shock, concomitant presence of other infections. RESULTS: Twelve Candida spp blood infections were diagnosed. All the risk factors were homogenously distributed between patients who survived and those who died with the exception of the malnutrition state, associated with a higher mortality rate. CONCLUSION: If the candidemia is present, none of the risk factors for the onset of fungemia considered in this study, but the malnutrition state, are mortality predictors.

Candidiasis↗
PubMedDate not supplied

The effects of hydroxyethyl starch solution in critically ill patients.

AIM: In the treatment of the critically ill patients an adequate fluid therapy appears to be essential to optimize hemodynamics and to get a suitable tissue perfusion. In this study we have evaluated the effects of volume replacement, carried out with 2 different solutions: hydroxyethyl starch 6% (HAES) and albumin 20% (HA). METHODS: Twenty patients suffering from sepsis were recruited and randomized into 2 groups. The first group was treated with hydroxyethyl starch 6% ( HAES treated group), and the second with albumin 20% (HA treated group). The volume of colloids was given to maintain pulmonary capillary wedge pressure (PCWP) between 15 and 18 mmHg. Daily, both hemodynamic parameters and blood gas analyses were monitored. RESULTS: Groups were homogeneous for age, sex and pathology. During the treatment we observed that cardiac index (CI), right ventricular ejection fraction (RVEF), oxygen consumption index (VO(2)I), oxygen delivery index (DO(2)I), and rate between arterial oxygen pressure and fraction of inspired oxygen (PaO(2)/FiO(2)) were increased significantly only in HAES treated group (P<0.05). APACHE II score decreased significantly only in HAES treated group (P<0.05), contrarily to the HA treated group, in which we observed a non significant increase. CONCLUSIONS: Since hydroxyethyl starch induced a hemodynamic and clinical improvement, these effects translated into an improvement of sensorium and a reduction of APACHE II score, without causing pulmonary edema, we can conclude that hydroxyethyl starch 6% ws 130,000 dalton ms 0.4 (Voluven) is an effective fluid for resuscitation of hypovolemic patients and represent an attractive alternative to albumin.

Adult↗