Critical care medicine
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Critical care medicine · Jan 2003
Randomized Controlled Trial Multicenter Study Clinical TrialDrotrecogin alfa (activated) administration across clinically important subgroups of patients with severe sepsis.
To assess the effects of drotrecogin alfa (activated) therapy, a recombinant human activated protein C, across clinically relevant subpopulations in a randomized, phase 3, placebo-controlled study of patients with severe sepsis (recombinant human activated protein C worldwide evaluation in severe sepsis [PROWESS]). ⋯ The administration of drotrecogin alfa (activated) to patients with severe sepsis was associated with a significant survival benefit that tended to increase with higher baseline likelihood of death. Current data suggest that the increased risk of bleeding does not vary according to likelihood of death.
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Critical care medicine · Jan 2003
Randomized Controlled Trial Multicenter Study Clinical TrialImpact of oligon central venous catheters on catheter colonization and catheter-related bloodstream infection.
To evaluate a new antimicrobial treatment for central venous catheters in comparison with a traditional treatment, by assessing the catheter colonization and catheter-related bloodstream infection rates in two groups of patients. ⋯ Oligon treatment is effective in limiting the catheter colonization rate. Due to the limited amount of events, this study lacked the power to detect significant differences in terms of catheter-related bloodstream infection rate.
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Critical care medicine · Jan 2003
Randomized Controlled Trial Multicenter Study Clinical TrialCost-effectiveness of drotrecogin alfa (activated) in the treatment of severe sepsis.
To assess the cost-effectiveness of drotrecogin alfa (activated) therapy, which was recently shown to reduce mortality in severe sepsis. ⋯ Drotrecogin alfa has a cost-effectiveness profile similar to that of many well-accepted healthcare strategies and below commonly quoted thresholds.
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Critical care medicine · Jan 2003
Review Meta AnalysisFulminant hepatic failure secondary to acetaminophen poisoning: a systematic review and meta-analysis of prognostic criteria determining the need for liver transplantation.
To summarize and compare different prognostic criteria used to determine need for liver transplantation in patients with fulminant hepatic failure secondary to acetaminophen poisoning. ⋯ Presently, available criteria are not very sensitive and may miss patients requiring transplantation. Future studies should further evaluate the efficacy of the APACHE II criteria.
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Critical care medicine · Jan 2003
Review Randomized Controlled Trial Clinical TrialDrotrecogin alfa (activated) (recombinant human activated protein C) for the treatment of severe sepsis.
To review the data supporting drotrecogin alfa (activated) for severe sepsis treatment. ⋯ Coagulopathy and systemic inflammation are almost universal in patients with severe sepsis. Treatment of this disorder with drotrecogin alfa (activated) directly addresses these derangements and substantially reduces morbidity and mortality rates with potential for bleeding during infusion as the only known risk.