Critical Care and Shock

November 2007

Spontaneous Escherichia Coli Meningitis in an Adult

Escherichia coli meningitis has been reported rarely in adult patients. Moreover, it is very rare in an adult patient without diabetes mellitus or neurosurgical shunts. Even with treatment, it carries a high mortality ranging from 27% to 90%, and mortality without treatment is 100% [1-3].
We describe a rare case of an adult patient, without known predisposing factors such as diabetes mellitus or neurosurgical shunts, who presented with E. coli meningitis.

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Endotracheal Cuff Pressures in Ventilated Patients in Intensive Care

There are well over 50,000 patients who receive ventilation via an endotracheal tube in the Intensive Care Units (ICUs) in Australia and New Zealand every year. Almost all episodes of invasive ventilation in adults are associated with inflation of endotracheal cuff. While monitoring of the cuff pressure has been recommended during anaesthesia this has not been reflected in any of the minimum standards documents.

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Natural History and Risk Factors of the “Cholestatic Post-cardiac Surgery Syndrome”

Jaundice following cardiac surgery, frequently referred to as “post-pump jaundice,” has been reported since the 1960’s with an incidence of between 3 to 40%. The incidence of jaundice following mitral valve replacement has been reported to be as high as 55%. Jaundice following cardiac surgery has been associated with prolonged mechanical ventilation, prolonged intensive care unit (ICU) stay, and a higher mortality. The causes of jaundice following cardiac surgery include acute cholecystitis, acute pancreatitis, shocked liver, and septic shock.

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Year in Review 2006: The Critically Ill Patient in the Pediatric ICU

The care of the critically ill patient in the pediatric intensive care unit (PICU) has remained an important topic for those health care providers dealing with children. The purpose of this article is to introduce to the reader a summary of selected papers which we consider relevant to the care of the pediatric critically ill patient and that were published in the year 2006. These articles were selected on the basis of application to the PICU, overall importance and are not to be solely considered authoritative in their field. There are many other useful articles.

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