Critical care medicine
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Critical care medicine · Jan 2013
Physical and mental health in patients and spouses after intensive care of severe sepsis: a dyadic perspective on long-term sequelae testing the Actor-Partner Interdependence Model.
To examine the physical and mental long-term consequences of intensive care treatment for severe sepsis in patients and their spouses under consideration of a dyadic perspective using the Actor-Partner Interdependence Model. ⋯ Interventions to treat posttraumatic stress symptoms after critical illness to improve mental health-related quality of life should not only include patients, but also consider spouses.
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Critical care medicine · Jan 2013
Evolution over a 15-year period of clinical characteristics and outcomes of critically ill patients with community-acquired bacteremia.
In recent years, outcomes for critically ill patients with severe sepsis have improved; however, no data have been reported about the outcome of patients admitted for community-acquired bacteremia. We aimed to analyze the changes in the prevalence, characteristics, and outcome of critically ill patients with community-acquired bacteremia over the past 15 yrs. ⋯ The prevalence of community-acquired bacteremia in ICU patients has increased. Despite a higher percentage of more severe and older patients, the mortality associated with community-acquired bacteremia decreased. Improved management of severe sepsis might explain the improvements in outcomes.
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Critical care medicine · Jan 2013
Cecal ligation and puncture-induced murine sepsis does not cause lung injury.
The cause of death in murine models of sepsis remains unclear. The primary purpose of this study was to determine if significant lung injury develops in mice predicted to die after cecal ligation and puncture-induced sepsis compared with those predicted to live. ⋯ These data demonstrate that mice predicted to die during sepsis have no significant lung injury. In murine intra-abdominal sepsis, pulmonary injury cannot be considered the etiology of death in the acute phase.
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Opioids are frequently used during mechanical ventilation for severe viral infection in infancy. Opioid receptors have immunomodulatory properties, but nothing is known about their antiviral effects. We therefore aimed to investigate the role of opioid receptors in virus-induced airway inflammation. ⋯ Using a human study and an experimental model, we show that opioid receptor signaling has a potential beneficial role in the outcome of respiratory viral disease. We show that opioid receptor signaling is required to control respiratory syncytial virus replication and thereby to control disease severity. However, we also show that caution is required before using pharmaceutical opioids as anti-inflammatory or antiviral treatment of patients with viral respiratory infection.