Various guidelines and recommendations are available for the use of natriuretic peptides in the diagnosis of heart failure. As it is known that old age may lead to higher natriuretic peptide values in the absence of heart failure, it is relevant to decide whether to use age-dependent reference intervals for clinical...

Patients with sepsis, severe sepsis and/or septic shock are at increased risk of death and organ dysfunction.  While morbidity and mortality of patients with severe traumatic injury, acute myocardial infarction or stroke have been significantly reduced during recent years by the implementation of well-coordinated...

The following is a copy of an article from Nursing 2007, Fall 2007 Volume 37 Number 8 - Supplement: ED Insider, Pages 14 - 16 The D-dimer level is a measure of clot formation and lysis that results from the degradation of cross-linked fibrin. Widely used as an indicator for the presence of disseminated intravascular ...

Over the years, as clinicians have learned how to utilize it, permissive hypercapnia has been finding a place in healthcare. However, it is important to bear in mind that numbers do not tell the entire story. It is imperative to understand the entire clinical picture before you act. For example, an acidic pH of 7.21...

BACKGROUND: Besides actual pH, base excess (ctH⁺_B (mmol/L)) is of major importance since it is meant to reflect lactate acidosis due to fetal hypoxia; in vivo BE_B is not independent from pCO₂. Independence is achieved by using the extended extracellular fluid (Ecf) for dilution of hemoglobin (cHb_B), reducing cHb_B to ...

PURPOSE – The purpose of this article is to discuss lean as a learning system in a hospital ward. DESIGN/METHODOLOGY/APPROACH – Discusses lean as a learning system in a hospital ward. FINDINGS – The Toyota veterans are fond of saying, lean is about “making people before making parts” or, in the wards’ context,...

The following is a copy of an article from Evidence-Based Practice, 2007; 10(12):1-2. Venous thromboembolism refers to a spectrum of disease that includes both pulmonary embolus and deep-venous thrombosis (DVT). More than 250,000 people in the United States are diagnosed annually with venous thromboembolic disease;...

PURPOSE – The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. DESIGN/METHODOLOGY/APPROACH – This paper is a viewpoint. FINDINGS – One’s...

CONTEXT: Sensitive D-dimer assays have been developed to exclude the diagnosis of deep vein thrombosis (DVT) and have exhibited great success when used in conjunction with a diagnostic algorithm, including pretest probability scoring and a compression ultrasound (CUS). Improving specificity of D-dimer assays would...

Tight glycemic control (TGC) in the intensive care unit is essential to comprehensive clinical management.  However, TGC that is too aggressive in the wrong patient populations (particularly non-diabetics) can result in hypoglycemia, which brings with it a set of sequelae that can increase morbidity and mortality....