Critical care medicine
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Critical care medicine · Mar 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialAlcoholic povidone-iodine to prevent central venous catheter colonization: A randomized unit-crossover study.
To compare effectiveness in preventing central venous catheter colonization and infection of two protocols of cutaneous antisepsis using povidone-iodine solution in combination with ethanol or water. ⋯ The use of alcoholic povidone-iodine for skin disinfection reduced the incidence of catheter colonization and related infection compared with aqueous 10% povidone-iodine disinfection in an adult intensive care unit.
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Critical care medicine · Mar 2004
Review Practice Guideline GuidelineSurviving Sepsis Campaign guidelines for management of severe sepsis and septic shock.
In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for severe sepsis and septic shock that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and improve outcome in severe sepsis. ⋯ Evidence-based recommendations can be made regarding many aspects of the acute management of sepsis and septic shock that are hoped to translate into improved outcomes for the critically ill patient. The impact of these guidelines will be formally tested and guidelines updated annually and even more rapidly as some important new knowledge becomes as available.
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Critical care medicine · Mar 2004
Multicenter StudyRed blood cell transfusion and ventilator-associated pneumonia: A potential link?
To determine the relationship between packed red blood cell transfusion practice and the development of ventilator-associated pneumonia (VAP). ⋯ Transfusion of packed red blood cells increases the risk of developing VAP. Avoiding the unnecessary use of packed red blood cell transfusions may decrease the occurrence of VAP.
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Critical care medicine · Mar 2004
Randomized Controlled Trial Multicenter Study Clinical TrialAlbumin influences total plasma antioxidant capacity favorably in patients with acute lung injury.
To ascertain the influence of albumin on antioxidant status in patients with acute lung injury. ⋯ In patients with acute lung injury, albumin administration favorably influences plasma thiol-dependent antioxidant status as well as levels of protein oxidative damage.
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Critical care medicine · Mar 2004
Multicenter StudyElevated plasma and lung endothelial selectin levels in patients with acute respiratory distress syndrome and a history of chronic alcohol abuse.
Activation of endothelial cells is a critical step in the pathogenesis of acute respiratory distress syndrome (ARDS). Soluble endothelial selectin (sE-selectin), an endothelial cell-specific molecule that mediates leukocyte-endothelial cell adhesion has never been measured in the bronchoalveolar lavage fluid of critically ill patients. Based on the effects of alcohol on endothelial cell and alveolar-capillary barrier function, we hypothesized that chronic alcohol exposure may be associated with increased sE-selectin in ARDS patients. ⋯ ARDS patients who chronically abuse alcohol have elevated concentrations of sE-selectin in both the plasma and epithelial lining fluid consistent with altered endothelial cell and alveolar-capillary barrier function.