Critical care medicine
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Critical care medicine · Jul 2003
Randomized Controlled Trial Comparative Study Clinical TrialFluconazole improves survival in septic shock: a randomized double-blind prospective study.
To demonstrate whether fluconazole reduces multiple organ failure and mortality in early septic shock (<24 hrs). ⋯ The development of organ failure and mortality in septic shock was significantly reduced by fluconazole given intravenously. The mechanism of action of fluconazole in reducing multiple organ dysfunction in this group of patients may be attributed to the ability of fluconazole to increase recruitment, improve bactericidal activity of neutrophils, and to contain microorganisms locally.
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Critical care medicine · Jul 2003
Multicenter StudyGender-related differences in intensive care: a multiple-center cohort study of therapeutic interventions and outcome in critically ill patients.
To determine whether gender-related differences exist in the provided level of care and outcome in a large cohort of critically ill patients. ⋯ In a large cohort of critically ill patients, no differences in severity of illness-adjusted mortality rate between men and women were found. Despite a higher severity of illness in women, men received an increased level of care and underwent more invasive procedures. This different therapeutic approach in men did not translate into a better outcome.
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Critical care medicine · Jul 2003
Epidemiology and impact of aspiration pneumonia in patients undergoing surgery in Maryland, 1999-2000.
The epidemiology of aspiration pneumonia and its impact on clinical and economic outcomes in surgical patients are poorly defined. We sought to identify preoperative patient characteristics and surgical procedures that are associated with an increased risk for aspiration pneumonia and to determine the clinical and economic impact in hospitalized surgical patients. ⋯ Aspiration pneumonia occurs in approximately 1% of surgical patients and is associated with significant morbidity, mortality, and costs of care. Given that the rate of aspiration pneumonia varies among hospitals, we can improve the quality and reduce the costs of care by implementing strategies to reduce the rate of aspiration pneumonia.
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Critical care medicine · Jul 2003
Optimal timing for electrical defibrillation after prolonged untreated ventricular fibrillation.
It currently is recommended that electrical shocks be delivered immediately on recognition of ventricular fibrillation. However, decreased effectiveness of this approach has been reported after prolonged intervals of untreated ventricular fibrillation. We investigated the optimal strategy for successful defibrillation after prolonged untreated ventricular fibrillation by using a rat model of ventricular fibrillation and closed-chest resuscitation. ⋯ Improved outcome after prolonged untreated ventricular fibrillation may result from strategies that provide chest compression before attempting defibrillation and avoid early and repetitive defibrillation attempts. The amplitude and frequency characteristics of the ventricular fibrillation waveform could help identify the optimal timing for attempting electrical defibrillation.