Chest
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To identify the typical duration of postoperative mechanical ventilation following coronary artery bypass graft surgery (CABG), and to identify risk factors for prolonged postoperative ventilation. ⋯ Typically, patients can be expected to be extubated within 3 days after CABG. Certain preoperative comorbidities, especially preoperative cardiac or respiratory instability, are predictive of prolonged postoperative mechanical ventilation.
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To identify the risk of thromboembolism after withholding or reversing the effect of warfarin therapy following a major hemorrhage. ⋯ Thromboembolic risk is low in prosthetic heart valve patients hospitalized with major hemorrhage when their warfarin therapy is reversed or withheld. Recurrent bleeding within 6 months of the resumption of anticoagulation is common, and aggressive treatment of the bleeding source and the risk-benefit ratio of continued anticoagulation need to be considered.
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Comparative Study
A study of consecutive autopsies in a medical ICU : a comparison of clinical cause of death and autopsy diagnosis.
To determine the degree of concordance between clinical cause of death and autopsy diagnosis in a medical ICU (MICU) setting. ⋯ Younger patients tended to have a higher autopsy rate than older patients. The discordance between the clinical cause of death and postmortem diagnosis was 19.8%. In 44.4% of the discordant cases, knowledge of the correct diagnosis would have altered therapy.
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Clinical Trial
The 24-h effect of mannitol on the clearance of mucus in patients with bronchiectasis.
To investigate the acute effect of mannitol on the clearance of mucus, and (1) the 24-h mucus retention, and (2) the mucus clearance rate and lung function 24 h after inhalation of a single dose of mannitol. ⋯ Mannitol inhalation acutely increases clearance of mucus, and this effect extends beyond the acute study period, resulting in decreased mucus retention at 24 h.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Filgrastim in patients with pneumonia and severe sepsis or septic shock.
Evaluate the safety of filgrastim (recombinant methionyl human granulocyte colony-stimulating factor) administration, combined with standard therapy, in patients with pneumonia and either septic shock or severe sepsis who were receiving mechanical ventilation. ⋯ Filgrastim appeared to be well tolerated in this population of patients with pneumonia and severe sepsis or septic shock. Larger studies to determine the benefit of filgrastim in patients with pneumonia and sepsis or organ dysfunction are warranted.