Critical care medicine
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Critical care medicine · Nov 2011
Randomized Controlled Trial Multicenter StudyEffect of pravastatin on the frequency of ventilator-associated pneumonia and on intensive care unit mortality: open-label, randomized study.
To investigate whether the use of pravastatin reduces the frequency of ventilator-associated pneumonia and whether it is related to favorable outcomes in critical care patients. ⋯ This study provides evidence that pravastatin may favorably affect the outcome of critical care patients.
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Critical care medicine · Nov 2011
Multicenter StudyAssociation of prehospitalization aspirin therapy and acute lung injury: results of a multicenter international observational study of at-risk patients.
To evaluate the association between prehospitalization aspirin therapy and incident acute lung injury in a heterogeneous cohort of at-risk medical patients. ⋯ After adjusting for the propensity to receive aspirin therapy, no statistically significant associations between prehospitalization aspirin therapy and acute lung injury were identified; however, a prospective clinical trial to further evaluate this association appears warranted.
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Critical care medicine · Nov 2011
Comparative StudyIntensive care unit renal support therapy volume is not associated with patient outcome.
Evidence suggests that patients requiring high-risk procedures benefit from care at institutions providing a large volume of these procedures. Our objective was to determine whether there is a volume-outcome relationship among intensive care unit patients receiving renal support therapy in two different healthcare systems (France and the United States). ⋯ There is a large variation in annual renal support therapy volume across intensive care units in France and the United States but no association of higher volumes with improved outcomes.
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Critical care medicine · Nov 2011
Antibiotic exposure and resistance development in Pseudomonas aeruginosa and Enterobacter species in intensive care units.
We quantified the association between antibiotic exposure and acquisition of antibiotic resistance in Pseudomonas aeruginosa and Enterobacter species in intensive care unit patients. ⋯ Meropenem exposure is associated with the highest risk of resistance development in P. aeruginosa. Increasing carbapenem use attributable to emergence of Gram-negative bacteria producing extended-spectrum β-lactamases will enhance antibiotic resistance in P. aeruginosa.
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Critical care medicine · Nov 2011
Development and validation of a model that uses enhanced administrative data to predict mortality in patients with sepsis.
We aimed to determine whether a sepsis risk-adjustment model that uses only administrative data could be used when other intensive care unit risk-adjustment methods are unavailable. ⋯ A sepsis mortality model using detailed administrative data has discrimination similar to and calibration superior to those of existing severity scores that require chart review. This model may be a useful alternative method of severity adjustment for benchmarking purposes or for conducting large, retrospective epidemiologic studies of sepsis patients.