All consecutive patients admitted to our university hospital PICU from June 1998 through to May 2000 were included unless they met the following exclusion criteria: admission in a state requiring cardiopulmonary resuscitation without achieving stable vital signs for at least 2 hours; admission for scheduled procedures normally done in other hospital wards; prematurity; and age more than 18 years.
Exclusion criteria were the following: age of 18 years or older, prematurity, pregnancy, PICU length of stay of less than 4 hours, admission in a state of continuous cardiopulmonary resuscitation without achieving stable vital signs for at least 2 hours, transfer to another PICU, and admission for scheduled procedures normally cared for in other hospital locations.
Exclusion criteria were: age 18 years or older; premature at entry into PICU; pregnancy; total length of stay in PICU less than 4 h; admission in a state of continuous cardiopulmonary resuscitation without achieving stable vital signs for at least 2 h; transfer from another PICU; and admissions for scheduled procedures normally performed in other hospital locations.
Whether some patients would benefit from better resuscitation efficiency (that is, achieving resuscitation goals faster with less fluid) even at the expense of some renal toxicity cannot be addressed by this or the 6S trial.
The major elements of the "6-hour resuscitation bundle" of the Surviving Sepsis Campaign Guidelines include fluid resuscitation to achieve a central venous pressure (CVP) of >8 cmH2or(or 12 cmH2O when on a ventilator) and a central venous oxygen saturation (ScvO2) > 70% with the use of blood and inotropic agents.
Of the resuscitation bundle elements, achieving targets for fluid resuscitation and vasopressors was associated with survival, but this disappeared when adjusted for APACHE II score.
In the 1960s cardio-pulmonary resuscitation (CPR) achieved what we had been attempting for centuries – restarting the heart and lungs of the recently dead.
Using cardiopulmonary bypass (CPB), resuscitation was achieved, and the patient had no neurological deficits.
In Figure 2 it is shown that, in ED patients admitted to the ICU, time to antibiotics is shorter, amount of administered fluids is larger and number of goals of the SSC resuscitation bundle achieved in the ED is higher in patients with PIRO score 1 14.
Resuscitation was achieved using hydroxyethyl starch (up to 20 ml/kg) and norepinephrine infusion (up to 10 μg/kg/minute).
Only in a very limited number of patients were the resuscitation goals achieved in the preoperative and intraoperative periods.
