降低血培养标本污染率因素的探讨

血培养标本的污染可发生在采血的各个环节,而由污染造成的假阳性结果不仅延误了临床上的诊断与治疗,也增加了患者的经济负担。因此,采用一种能够有效避免标本采集污染的方法极为重要。我科2002年10月-2006年9月共抽     

Debate: Albumin administration should not be avoided

The recent Cochrane report on albumin administration is analysed and criticised on the grounds of clinical methodology, content and interpretation. Although it is naïve and illogical to treat hypoalbuminaemia with albumin infusions, a more balanced view on the use of albumin for resuscitation in acute hypovolaemia is necessary. Once the acute phase of critical illness is past, interstitial volume is often expanded causing oedema, with a low plasma volume. We argue for the use of salt-poor albumin solutions in this situation and conclude that, on current evidence, the assertion that albumin should be avoided in all situations is irrational and untenable.     

Extubation failure: an outcome to be avoided

Extubation failure is an outcome of increasing importance but nearly all studies have been conducted in academic settings. The article by Seymour and colleagues demonstrates that extubation failure is an outcome to be avoided in the community hospital setting as well. Patients failing extubation experience longer lengths of stay, experience higher intensive care unit mortality, and incur greater hospital costs. Investigators have identified tools for predicting extubated patients at highest risk for reintubation. The predictors focus on detecting upper airway obstruction, inadequate cough, excess respiratory secretions, and abnormal mental status. Systematic application of these predictors has the potential to improve outcome.