Journal of critical care
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Journal of critical care · Apr 2016
Azithromycin use and outcomes in severe sepsis patients with and without pneumonia.
Studies investigating the association between macrolides and outcomes in both pulmonary and nonpulmonary critically ill patients are limited. We aimed to examine the association between azithromycin use and clinical outcomes in severe sepsis patients with and without pneumonia receiving mechanical ventilation. ⋯ Azithromycin was associated with more ICU-free days in severe sepsis patients with and without pneumonia. Further investigations are warranted to better elicit the association of macrolide use on clinical outcomes in severe sepsis patients, especially those without pneumonia.
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Journal of critical care · Apr 2016
Herpes simplex virus in bronchoalveolar lavage fluid of medical intensive care unit patients: Association with lung injury and outcome.
In intensive care unit (ICU) patients in whom bronchoalveolar lavage fluid (BALF) was analyzed for suspected infectious pulmonary disease, we investigated the association of herpes simplex virus (HSV) in the BALF with lung injury and patient outcome. ⋯ We did not find a clinically relevant or statistically significant association of HSV in the BALF of medical ICU patients with lung injury or with ICU and hospital mortality.
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Journal of critical care · Apr 2016
The predictive value of soluble endothelial selectin plasma levels in children with acute lung injury.
The study aimed to evaluate the value of soluble endothelial selectin (sE-selectin) plasma level measurement in predicting acute lung injury (ALI) outcome in children. ⋯ Plasma sE-selectin level served as a good predictor biomarker for both mechanical ventilation duration and the mortality risk in children with ALI.
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Journal of critical care · Apr 2016
Observational StudyDevelopment and validation of the "Pediatric Risk of Nosocomial Sepsis (PRiNS)" score for health care-associated infections in a medical pediatric intensive care unit of a developing economy-a prospective observational cohort study.
Given the high burden of health care-associated infections (HAIs) in resource-limited settings, there is a tendency toward overdiagnosis/treatment. This study was designed to create an easy-to-use, dynamic, bedside risk stratification model for classifying children based on their risk of developing HAIs during their pediatric intensive care unit (PICU) stay, to aid judicious resource utilization. ⋯ The "Pediatric Risk of Nosocomial Sepsis" score can reliably classify children into high- and low-risk groups, based on their risk of developing HAIs in the PICU of a resource-limited setting. In view of its high sensitivity and specificity, diagnostic and therapeutic interventions may be directed away from the low-risk group, ensuring effective utilization of limited resources.
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Journal of critical care · Apr 2016
Comparative Study Observational StudyThe effect of physician staffing model on patient outcomes in a medical progressive care unit.
Although evidence supports the impact of intensivist physician staffing in improving intensive care unit (ICU) outcomes, the optimal coverage for progressive care units (PCU) is unknown. We sought to determine how physician staffing models influence outcomes for intermediate care patients. ⋯ We found no evidence that high-intensity intensivist physician staffing improves outcomes for intermediate care patients. In a strained critical care system, our study raises questions about the role of the intensivist in the graded care options between intensive and conventional ward care.