Critical care medicine
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Critical care medicine · Oct 2014
Horizontal Infection Control Strategy Decreases Methicillin-Resistant Staphylococcus aureus Infection and Eliminates Bacteremia in a Surgical ICU Without Active Surveillance.
Methicillin-resistant Staphylococcus aureus infection is a significant contributor to morbidity and mortality in hospitalized patients worldwide. Numerous healthcare bodies in Europe and the United States have championed active surveillance per the "search and destroy" model. However, this strategy is associated with significant economic, logistical, and patient costs without any impact on other hospital-acquired pathogens. We evaluated whether horizontal infection control strategies could decrease the prevalence of methicillin-resistant S. aureus infection in the ICU, without the need for active surveillance. ⋯ Aggressive multifaceted horizontal infection control is an effective strategy for reducing the prevalence of methicillin-resistant S. aureus infection and eliminating methicillin-resistant S. aureus bacteremia in the ICU without the need for active surveillance and decontamination.
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Critical care medicine · Oct 2014
The Morbidity and Mortality Conference in PICUs in the United States: A National Survey.
Determine how many morbidity and mortality conferences in PICUs across the United States conform to key elements of medical incident analysis. ⋯ Morbidity and mortality conferences varied widely in structure and process across PICUs in the United States. There was marked disagreement as to whether the morbidity and mortality conference conforms to key elements of medical incident analysis, which might itself be revealing a lack of morbidity and mortality conference structure and consistency. Future research is needed to identify barriers to the use of the morbidity and mortality conference as a patient safety improvement tool and to test strategies for effective implementation linked to improved patient outcomes.
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Critical care medicine · Oct 2014
Lung-Targeted RNA Interference Against Angiopoietin-2 Ameliorates Multiple Organ Dysfunction and Death in Sepsis.
Angiopoietin-2, a protein secreted by stimulated endothelium and an antagonist of the endothelium-stabilizing receptor Tie2, contributes to the pathophysiology of septic multiple organ dysfunction. We tested the therapeutic potential of a pulmonary-endothelium-specific RNA interference-based angiopoietin-2 targeting strategy in sepsis. ⋯ The Tie2 antagonist angiopoietin-2 represents a promising target against sepsis-associated multiple organ dysfunction. A novel RNA interference therapeutic approach targeting gene expression in the pulmonary endothelium could be a clinically relevant pharmacological strategy to reduce injurious angiopoietin-2 synthesis.