Critical care medicine
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Critical care medicine · Jul 2011
Multicenter StudyThe epidemiology of sepsis in Colombia: a prospective multicenter cohort study in ten university hospitals.
Our aim was to determine the frequency and the clinical and epidemiologic characteristics of sepsis in a hospital-based population in Colombia. ⋯ In a general inpatient population of Colombia, the rates of severe sepsis and septic shock are higher than those reported in the literature. The observed mortality is higher than the predicted by the Acute Physiology and Chronic Health Evaluation II score.
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Critical care medicine · Jul 2011
ReviewNursing considerations to complement the Surviving Sepsis Campaign guidelines.
To provide a series of recommendations based on the best available evidence to guide clinicians providing nursing care to patients with severe sepsis. ⋯ Consensus was reached regarding many aspects of nursing care of the severe sepsis patient. Despite this, there is an urgent need for further evidence to better inform this area of critical care.
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Critical care medicine · Jul 2011
Randomized Controlled TrialA randomized trial of the effect of patient race on physicians' intensive care unit and life-sustaining treatment decisions for an acutely unstable elder with end-stage cancer.
To test whether hospital-based physicians made different intensive care unit and life-sustaining treatment decisions for otherwise identical black and white patients with end-stage cancer and life-threatening hypoxia. ⋯ In this exploratory study, hospital-based physicians did not make different treatment decisions for otherwise identical terminally ill black and white elders despite believing that black patients are more likely to prefer intensive life-sustaining treatment, and they grossly overestimated the preference for intensive treatment for both races.
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Critical care medicine · Jul 2011
International validation of the out-of-hospital cardiac arrest score in the United States.
Investigators in France have developed a risk score to predict death or poor neurologic outcome after out-of-hospital cardiac arrest. The aim of this study is to externally validate this score in an independent patient population in the United States. ⋯ This study found good calibration and high discrimination of the out-of-hospital cardiac arrest score in two geographically distinct patient populations in the United States. Particularly, this score had a high positive predictive value and performed well in identifying high-risk patients for poor outcomes.
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Critical care medicine · Jul 2011
Comparative StudyQuantitative computed tomography in porcine lung injury with variable versus conventional ventilation: recruitment and surfactant replacement.
Biologically variable ventilation improves lung function in acute respiratory distress models. If enhanced recruitment is responsible for these results, then biologically variable ventilation might promote distribution of exogenous surfactant to nonaerated areas. Our objectives were to confirm model predictions of enhanced recruitment with biologically variable ventilation using computed tomography and to determine whether surfactant replacement with biologically variable ventilation provides additional benefit in a porcine oleic acid injury model. ⋯ Quantitative computed tomography analysis confirms lung recruitment with biologically variable ventilation in a porcine oleic acid injury model. Surfactant replacement with biologically variable ventilation provided no additional recruitment benefit and may in fact be harmful.