reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. carbon dioxide 30 [27][28][29][30][31][32][33][34][35] mmHg and median temperature 37.1 [36.8-37.3]°C. After removal of artefacts, the mean monitoring time was 22 h08 (8 h54). All patients had impaired cerebral autoregulation during their monitoring time. The mean IAR index was 17 (9.5) %. During H 0 H 6 and H 18 H 24 , the majority of our patients; respectively 53 and 71 % had an IAR index > 10 %. Conclusion According to our data, patients with septic shock had impaired cerebral autoregulation within the first 24 hours of their admission in the ICU. In our patients, we described a variability of distribution of impaired autoregulation according to time.
ReferencesSchramm P, Klein KU, Falkenberg L, et al. Impaired cerebrovascular autoregulation in patients with severe sepsis and sepsis-associated delirium. Crit Care 2012; 16: R181. Aries MJH, Czosnyka M, Budohoski KP, et al. Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury. Crit. Care Med. 2012.
ObjectivesTo analyze the colonization and infection rate of patients after discharge from an the Intensive Care Unit (ICU) with Selective Digestive Decontamination (SDD).
MethodsIn a polyvalent ICU of 30 beds, from October 7 th to December 30 th 2014, SDD was applied to all patients requiring endotracheal intubation for more than 48 hours. We administered during the first four days intravenous cefotaxime plus enteral solution and a paste with colistin, tobramycin, and nystatin every 8 hours. Oropharyngeal, rectal and nasal swabs were obtained on admission, whether or not they received SDD and once weekly. To assess in the wards, after ICU discharge, colonization and development of hospital infections with germs originated in the ICU, pharyngeal and rectal swabs on the 3 th and 10 th day after ICU discharge were obtained and analyzed. Categorical variables were summarized as frequencies and percentages and number in means and standard deviations (SD) or median with interquartile ranges (IQR).
ResultsForty one patients were analyzed, 26 of them received SDD (63,4%) and 24 of them (92.3%) received standard SDD. Demographic data, and admission types are shown in Figure 1.Isolates with germs at ICU discharge and at hospital ward are shown in Figure 2.The most frequent findings were negative isolates. Those who were positive at ICU discharge remained positive, and the negative ones remained negative except in 2 patients (one patient with a yeast at discharge changed to Klebsiella pneumoniae, and the other one changed from normal flora to Pseudomonas aeruginosa). There was only 1 patient who developed an infection in the ward originated in the UCI independently of receiving or not SDD. The patient was colonized by Klebsiella pneumoniae in the ICU and later developed a Klebsiella pneumoniae urinary infection in the hospital ward. The most frequent isolated germs at discharge and in the ward were Pseudomona aeruginosa and Klebisella pneumoniae (9%).
ConclusionsAll but two of patients the investigated patients receiving SDD in ICU did not have any change in the etiology of colonization after ICU discharge. Only another patient developed an attributable multi-resistant ICU infection.
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