Chest
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Multicenter Study
Effects of the dual endothelin receptor antagonist bosentan in patients with pulmonary arterial hypertension: a 1-year follow-up study.
We report on the long-term safety and efficacy of bosentan treatment in patients with pulmonary arterial hypertension (PAH). ⋯ Long-term treatment with bosentan is safe and has sustained benefits on exercise capacity and hemodynamics in patients with PAH.
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To describe the perspectives of family members to the care provided to critically ill patients who died in the ICU. ⋯ The majority of families of patients who died in participating ICUs were satisfied with the end-of-life care provided. Adequate communication, good decision making, and respect and compassion shown to both the dying patient and their family are key determinants to family satisfaction.
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Multicenter Study
Community-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival.
The objectives were to characterize the prognostic factors and evaluate the impact of inappropriate empiric antibiotic treatment and systemic response on the outcome of critically ill patients with community-acquired bloodstream infection (BSI). ⋯ Inappropriate antimicrobial treatment is the most important influence on outcome in patients admitted to the ICU for community-acquired BSI, particularly in presence of septic shock or high degrees of severity. Initial broad-spectrum therapy should be prescribed to septic patients in whom the source is unknown or in those requiring vasopressors.
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To determine the impact of body mass index (BMI) on outcomes in critically ill patients. ⋯ Low BMI, but not high BMI, is associated with increased mortality and worsened hospital discharge functional status. LOS is increased in severely obese patients and, to a lesser extent, in underweight patients. Patients in the overweight and obese BMI groups may have improved mortality and discharge functional status.
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The physical and psychological effects of caregiving have been examined in several populations. To date, no one has examined the effects of caregiving on caregivers of patients receiving long-term mechanical ventilation (LTV) [patients who required > 4 days of continuous in-hospital mechanical ventilation] who reside in a home or institutional setting after hospital discharge. The purpose of this study was to describe the characteristics and examine depression, burden, overload, and physical health in this caregiver population over a 6-month period after hospital discharge. ⋯ Caregivers of patients receiving LTV in our sample have similar characteristics to other caregiving populations. However, our sample had higher depression scores than those reported for many other caregiver groups.