Critical care medicine
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Critical care medicine · Apr 2011
Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study.
To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. ⋯ Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use.
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Critical care medicine · Apr 2011
Prevention of post-cardiopulmonary bypass acute kidney injury by endothelin A receptor blockade.
The aim of this study was to determine whether administration of a specific endothelin A receptor antagonist, sitaxsentan sodium, would prevent the development of post-cardiopulmonary bypass acute kidney injury in swine. ⋯ In this model, post-cardiopulmonary bypass acute kidney injury is associated with endothelial dysfunction, regional tissue hypoxia, and proximal tubular epithelial cell stress but not acute tubular necrosis. Antagonism of the endothelin-1 A receptor reversed these changes and may represent a therapeutic target for the prevention of post-cardiac surgery acute kidney injury.
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Critical care medicine · Apr 2011
ReviewEvidence for quality indicators to evaluate adult trauma care: a systematic review.
Multiple quality indicators are available to evaluate adult trauma care, but their characteristics and outcomes have not been systematically compared. We sought to systematically review the evidence about the reliability, validity, and implementation of quality indicators for evaluating trauma care. ⋯ Although many quality indicators are available to measure the quality of trauma care, reliability evidence, validity evidence, and description of outcomes after implementation are limited.
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Critical care medicine · Apr 2011
Randomized Controlled TrialThe impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: a randomized crossover study in critical care units in two hospitals.
To determine the effect of enhanced cleaning of the near-patient environment on the isolation of hospital pathogens from the bed area and staff hands. ⋯ Enhanced cleaning reduced environmental contamination and hand carriage, but no significant effect was observed on patient acquisition of methicillin-resistant Staphylococcus aureus.
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Chest sonography has gained clinical significance in the diagnosis of various pulmonary, pleural, cardiac, and mediastinal emergency conditions. Therefore, the current role of emergency ultrasound are assessed. ⋯ The noninvasive ultrasound-based diagnosis is relatively portable permitting the technique to be performed at any time, in any place, and on any patient, an ideal method for emergency conditions. Sonography allows immediate diagnosis of pulmonary embolism, pneumothorax, pneumonia, pleural effusion as well as rib fracture, and it provides a basis for further diagnostic- and treatment-related decisions. The key sonographic features associated with these most common emergency chest diseases are illustrated herein.