Journal of critical care
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Journal of critical care · Mar 2010
Risk factors for the deterioration of oxygenation ratio in ventilated intensive care unit patients: a retrospective cohort study.
The aim of the study is to determine which factors are associated with the deterioration of Pao(2)/fraction of inspired oxygen (Fio(2)) ratio in patients with normal oxygenation at admission and ventilated according to a lung protective ventilation strategy. ⋯ Lung injury exacerbates during mechanical ventilation. In patients treated with a mean tidal volume of 7.9 mL/kg, controlled ventilation is a major risk factor.
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Journal of critical care · Mar 2010
Factors associated with anemia in patients with cancer admitted to an intensive care unit.
The study aimed to evaluate the relative impact of clinical and demographic factors associated with the prevalence and incidence of anemia (hemoglobin [Hb] <12 g/dL) in critically ill patients with cancer. ⋯ Clinical factors are more influential than demographic factors in the observed rates of prevalence and incidence of anemia in the ICU; thus, protocols are needed to identify subgroups of patients with cancer who could benefit from novel management strategies.
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Journal of critical care · Mar 2010
Insight in microcirculation and histomorphology during burn shock treatment using in vivo confocal-laser-scanning microscopy.
Microcirculatory disturbances are well known during shock; however, the accompanied histomorphological alterations are widely unknown. We used high resolution confocal-laser-scanning microscopy for the evaluation of microcirculation and histomorphology during Burn Shock treatment. ⋯ Confocal-laser-scanning microscopy provides a noninvasive tool for simultaneous evaluation of microcirculation and tissue histomorphology. It may help to assess the adequacy of and response to resuscitation of burn patients early after trauma.
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Journal of critical care · Mar 2010
Study of device use adjusted rates in health care-associated infections after implementation of "bundles" in a closed-model medical intensive care unit.
"Bundles" strategies improve health care-associated infection (HCAI) rates in medical intensive care units (MICUs). However, few studies have analyzed HCAI rates adjusted for the device removal component of the bundles. An observational study of adult MICU patients while using bundles to prevent HCAIs associated with endovascular catheters, mechanical ventilation, and urinary tract catheters was conducted. ⋯ Ventilator-associated pneumonia (VAP) per 1000 ventilator days diminished from 2.17 to 0.62 (uIRR, 0.29; 95% CI, 0.21-0.38; P < .0001). After adjustment for device use, aIRRs of CRBSI (0.14; 95% CI, 0.11-0.18), UTI (0.09; 95% CI, 0.06-0.12), and VAP (0.33; 95% CI, 0.22-0.47) declined significantly (P < .00001). Implementing comprehensive bundle strategies reduces HCAI beyond the impact of device removal.