Critical care medicine
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Critical care medicine · Apr 2012
Clinical TrialImpact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.
To evaluate whether a real-time electronic alert system or "AKI sniffer," which is based on the RIFLE classification criteria (Risk, Injury and Failure), would have an impact on therapeutic interventions and acute kidney injury progression. ⋯ The real-time alerting of every worsening RIFLE class by the acute kidney injury sniffer increased the number and timeliness of early therapeutic interventions. The borderline significant improvement of short-term renal outcome in the RIFLE class risk patients needs to be confirmed in a large multicenter trial.
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Critical care medicine · Apr 2012
Insurance and racial differences in long-term acute care utilization after critical illness.
To determine whether insurance coverage and race are associated with long-term acute care hospital utilization in critically ill patients requiring mechanical ventilation. ⋯ Differences in long-term acute care hospital utilization after critical illness appear driven by insurance status and hospital-level effects. Racial variation in long-term acute care hospital use is not seen after controlling for insurance status and is not seen in a group with uniform insurance coverage. Differential access to postacute care may be minimized by expanding commercial or Medicare insurance availability and standardizing long-term acute care admission criteria across hospitals.
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Pseudomonas aeruginosa bacteremia is a serious and life-threatening infection associated with high mortality. Among the multitude of virulence determinants possessed by P. aeruginosa, the type 3 secretion system has been implicated with more acute and invasive infection in respiratory diseases. However, the relationship between the type 3 secretion system and clinical outcomes in P. aeruginosa bacteremia has not been investigated. ⋯ The expression of type 3 secretion system exotoxins in bacteremic isolates of P. aeruginosa confers poor clinical outcomes independent of antibiotic susceptibility profile.
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Critical care medicine · Apr 2012
Comparative StudyA comparison of critical care research funding and the financial burden of critical illness in the United States.
To estimate federal dollars spent on critical care research, the cost of providing critical care, and to determine whether the percentage of federal research dollars spent on critical care research is commensurate with the financial burden of critical care. ⋯ The proportion of research dollars spent on critical care is lower than the percentage of healthcare expenditures related to critical illness.
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Critical care medicine · Apr 2012
A two-compartment mathematical model of endotoxin-induced inflammatory and physiologic alterations in swine.
To gain insights into individual variations in acute inflammation and physiology. ⋯ The approach described herein may aid in predicting inflammation and physiologic dysfunction in small cohorts of subjects with diverse phenotypes and outcomes.