Critical care medicine
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Critical care medicine · Feb 2012
Review Meta Analysis Comparative StudyEffects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies.
Catecholaminergic inotropes have a place in the management of low output syndrome and decompensated heart failure but their effect on mortality is debated. Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. A meta-analysis was conducted to determine the impact of levosimendan on mortality and hospital stay. ⋯ Levosimendan might reduce mortality in cardiac surgery and cardiology settings of adult patients.
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Critical care medicine · Feb 2012
Multicenter Study Comparative StudyZero risk for central line-associated bloodstream infection: are we there yet?.
Identify the longest period a central line remains free from central line-associated bloodstream infection during an 18-month insertion-bundle project. ⋯ The success of the insertion bundle was identified by improved analysis that identified that the safest dwell time was extended to the first 9 days for centrally inserted lines and up to day 7 for dialysis, peripherally inserted central catheters, and unspecified central line types. Given that three quarters of intensive care unit patients have their central line removed by day 7, zero risk for central line-associated bloodstream infection should be achievable in the majority of patients where clinicians comply with the clinician and patient insertion bundles.
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Critical care medicine · Feb 2012
Review Comparative StudyImproving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference.
Millions of patients are discharged from intensive care units annually. These intensive care survivors and their families frequently report a wide range of impairments in their health status which may last for months and years after hospital discharge. ⋯ Improving care for intensive care survivors and their families requires collaboration between practitioners and researchers in both the inpatient and outpatient settings. Strategies were developed to address the major themes arising from the conference to improve outcomes for survivors and families.