Intensive care medicine
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Intensive care medicine · Dec 2006
Editorial CommentThe hidden pulmonary dysfunction in acute lung injury.
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Intensive care medicine · Dec 2006
Randomized Controlled Trial Multicenter StudyImpact of piperacillin resistance on the outcome of Pseudomonas ventilator-associated pneumonia.
The impact of antibiotic resistance on the outcome of infections due to Gram-negative bacilli, especially Pseudomonas, remains highly controversial. STUDY OBJECTIVE, DESIGN, AND PATIENTS: We evaluated the impact of piperacillin resistance on the outcomes of Pseudomonas aeruginosa ventilator-associated pneumonia (VAP) for patients who had received appropriate empiric antibiotics before enrollment in the PNEUMA trial, a multicenter randomized study comparing 8 vs 15 days of antibiotics. ⋯ For patients with Pseudomonas VAP benefiting from appropriate empiric antibiotics, piperacillin resistance was associated with increased disease severity at VAP onset and higher 28-day crude mortality; however, after controlling for confounders, piperacillin-resistance was no longer significantly associated with 28-day mortality. The VAP recurrence rates and durations of ICU stay and mechanical ventilation did not differ for susceptible and resistant strains.
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Intensive care medicine · Dec 2006
Clinical TrialHigh-dose midazolam therapy for refractory status epilepticus in children.
To assess the efficacy of high-dose midazolam in the treatment of refractory status epilepticus in children. ⋯ Midazolam can offer control of refractory status epilepticus without significant morbidity.
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Intensive care medicine · Nov 2006
Molecular adsorbent recirculating system dialysis in patients with acute liver failure who are assessed for liver transplantation.
To assess the usefulness of dialysis with the molecular adsorbent recirculating system (MARS) in patients with acute liver failure who fulfil criteria for liver transplantation. ⋯ A statistically significant improvement of liver function was observed after MARS therapy. Transplant-free recovery was more frequent than expected. The apparent benefit of MARS dialysis to treat acute liver failure needs to be confirmed by a controlled study.