com); collaboration requests are welcome.”
“Surgical intensive care units (ICU) play a pivotal role in perioperative care of patients undergoing major abdominal surgery. Differences in quality

of care provided by medical staff in ICUs may be linked to improved outcome. This review aims to elucidate the relationship between quality of care at various ICUs and patient outcome, with the ultimate aim of identifying key measures for achieving optimal outcome.

We reviewed the literature in PubMed to identify current ICU structural and process concepts and variations before evaluating their CUDC-907 manufacturer respective impact on quality of care and outcome in major abdominal surgery.

ICU leadership, nurse and physician staffing, and provision of an intermediate care unit are important structural components that impact on patients’ outcome. A “”mixed ICU”" model, with intensivists primarily caring for the patients in close cooperation with the primary physician, seems to be the most effective ICU model. Surgeons’ involvement in intensive care is essential, and a close cooperation between surgeons and anesthesiologists is vital for good outcome.

Current general process concepts include early mobilization, enteral feeding, and optimal perioperative fluid management. To decrease failure-to-rescue rates, procedure-specific intensive care processes are particularly focused on the early detection, assessment, and timely and consistent treatment of complications.

Several structures selleck inhibitor and processes in the ICU have an impact on outcome in major abdominal surgery. ICU structures and care processes learn more connected with optimal outcome could be transmitted to other centers to improve outcome, independent of procedure volume.”
“Background. Patients with peripheral arterial disease (PAD) are at high risk of cardiovascular (CV) events and often have hypertension with a high pulse pressure (PP). We studied the prognostic value of ambulatory blood

pressure (ABP) in PAD patients with special reference to PP. Methods. 98 consecutive males with PAD had 24-h ABP measurements. The mean age was 68 years and CV comorbidity was prevalent. The outcome variable was CV events defined as CV mortality or any hospitalization for myocardial infarction, stroke or coronary revascularization. The predictive value of ABP variables was assessed by Cox regression. 90 age-matched men free of CV disease served as controls. Results. During follow-up (median 71 months), 36 patients and seven controls had at least one CV event. In PAD patients, 24-h PP (hazard ratios, HR, 1.48 (95% confidence interval, CI, 1.14-1.92), p < 0.01) predicted CV events. Office PP did not predict events in PAD patients (HR 1.15 (0.97-1.38), ns). In multivariate analysis, 24-h PP (HR 1.48 (1.12-1.95), p < 0.01) remained a predictor of CV events. Conclusions. Ambulatory PP predicts CV events in patients with PAD. ABP measurement may be indicated for better risk stratification in PAD patients.