Critical care medicine
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Critical care medicine · Apr 2012
Multicenter StudyThe changing pattern and implications of multiple organ failure after blunt injury with hemorrhagic shock.
To describe the incidence of postinjury multiple organ failure and its relationship to nosocomial infection and mortality in trauma centers using evidence-based standard operating procedures. ⋯ Multiple organ failure remains common after severe injury. Contrary to current paradigms, the onset is only early, and not bimodal, nor is it associated with a "second-hit"-induced late onset. Multiple organ failure is associated with subsequent nosocomial infection and increased mortality. Standard operating procedure-driven interventions may be associated with a decrease in late multiple organ failure and morbidity.
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Critical care medicine · Apr 2012
Multicenter StudyA multicenter mortality prediction model for patients receiving prolonged mechanical ventilation.
Significant deficiencies exist in the communication of prognosis for patients requiring prolonged mechanical ventilation after acute illness, in part because of clinician uncertainty about long-term outcomes. We sought to refine a mortality prediction model for patients requiring prolonged ventilation using a multicentered study design. ⋯ The ProVent probability model is a simple and reproducible model that can accurately identify patients requiring prolonged mechanical ventilation who are at high risk of 1-yr mortality.
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Critical care medicine · Apr 2012
Transfer of multidrug-resistant bacteria to healthcare workers' gloves and gowns after patient contact increases with environmental contamination.
To assess the role of environmental contamination in the transmission of multidrug-resistant bacteria to healthcare workers' clothing. ⋯ The contamination of healthcare workers' protective clothing during routine care of patients with multidrug-resistant organisms is most frequent with A. baumannii. Environmental contamination was the major determinant of transmission to healthcare workers' gloves or gowns. Compliance with contact precautions and more aggressive environmental cleaning may decrease transmission.
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Critical care medicine · Apr 2012
Editorial CommentGrading inhalation injury by admission bronchoscopy.