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Aerosolized tobramycin is well tolerated in children and adults with cystic fibrosis (CF). It represents a potential alternative to intravenous administration of antibiotics to control respiratory infection with Pseudomonas aeruginosa. Although its exact role in acute therapy for a CF exacerbation is not known, it has been shown to improve lung function and reduce the frequency of exacerbations in the chronic stable outpatient.
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To examine ICU admission rates and diagnoses of patients with HIV infection and to determine the outcomes of different critical illnesses. ⋯ There is a diverse range of indications for critical care in patients with HIV infection. Although respiratory failure due to PCP was the most common reason for admission to the ICU, it accounted for only 34% of the cases. The prognosis of PCP in patients who require mechanical ventilation despite adjunctive corticosteroid treatment is poor.
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Anesthetic, sedative, and analgesic drugs have been shown in animals and humans to selectively impair upper airway muscle activity. In patients with an already compromised upper airway, these drugs may further jeopardize upper airway patency, especially during sleep. Thus, patients with obstructive sleep apnea syndrome (OSAS) are at high risk for surgery because of the use of the aforementioned drugs in the perioperative period. ⋯ The intensive care unit and hospital stays were the normal ones for each type of surgery in our institution. We conclude that N-CPAP started before surgery and resumed immediately after extubation allowed us to safely manage a variety of surgical procedures in patients with OSAS, and to freely use sedative, analgesic, and anesthetic drugs without major complications. Every effort should be made to identify patients with OSAS and institute N-CPAP therapy before surgery.