clinicaltrials.gov Identifier: NCT01130181.

Indoor microbial communities play an important role in everyday human health, especially in the intensive care units (ICUs) of hospitals. We used amplicon pyrosequencing to study the ICU microbiome and were able to detect diverse sequences, in comparison to the currently used standard cultivation technique that only detected 2.5% of the total bacterial diversity. The phylogenetic spectrum combined species associated with the outside environment, taxa closely related to potential human pathogens, and beneficials as well as included 7 phyla and 76 genera. In addition, Propionibacterium spp., Pseudomonas spp., and Burkholderia spp. were identified as important sources of infections. Despite significantly different bacterial area profiles for floors, medical devices, and workplaces, similarities by network analyses and strains with identical molecular fingerprints were detected. This information will allow for new assessment of public health risks in ICUs, help create new sanitation protocols, and further our understanding of the development of hospital-acquired infections.

MELD is superior to ICG PDR for estimation of short-term survival in patients with decompensated cirrhosis.

The eMPC algorithm was effective in maintaining tight glycaemic control in severely ill medical ICU patients.

When reactive oxygen species attack biological structures, peroxides, which are short-lived oxidative intermediates, are generated. We evaluated the potential of two different, commercially available peroxide activity assays (Pox-Act and d-ROMS) to see whether the results were associated with the clinical condition of subjects who were participating in a routine health care program. Furthermore, we determined the total antioxidant status (TAS) and the titer of autoantibodies against oxidized low-density lipoprotein (oLAb) to verify the hydroperoxide measurements. Subjects with medical conditions (hereafter referred to as patients) had significantly increased serum peroxide levels compared to healthy subjects. The d-ROMS kit indicated that 86% of subjects had an increased level of total peroxides. Although the assays had a significant correlation (p<0.001), 34% of the subjects had an increased total peroxide concentration in the Pox-Act assay that was clearly associated with clinical symptoms. Furthermore, the sensitivity of the Pox-Act assay was 35 times higher than that of the d-ROMS kit. In subjects with medical conditions, there was a trend toward a decreased TAS and a slightly increased oLAb titer in comparison to healthy subjects, but this was not statistically significant. The Pox-Act assay seems to be a valuable tool for the determination of total peroxides, while the results from the d-ROMS kit should be considered with caution.

SGC is a safe and efficient method to control blood glucose in critically ill patients in the medical intensive care unit.

The CNAP device provided feasible estimates of BP in unselected medical ICU patients under routine clinical conditions. Mean arterial pressure met interchangeability criteria for accuracy toward radial arterial pressure, as well as for percentage error, and showed good trending capabilities according to the Critchley predefined criteria.

No abstract