Critical care medicine
-
Critical care medicine · Mar 2014
Comparative StudyLung Injury and Its Prognostic Significance in Acute Liver Failure.
Hypoxemia is a feared complication of acute liver failure, and high oxygen requirements will frequently lead to removal of patients from the transplant list. As data regarding the prevalence and outcome of acute respiratory distress syndrome in acute liver failure are scant and hypoxemia being a commonly encountered systemic complication, we analyzed radiological, gas exchange, and ventilator data in consecutive patients admitted with acute liver failure. ⋯ The prevalence of lung injury is relatively low in acute liver failure, where 21% fulfilled acute respiratory distress syndrome criteria. Overall presence of acute respiratory distress syndrome appeared to have a limited impact on outcome.
-
Critical care medicine · Mar 2014
Observational StudyCentral Venous Catheter Placement by Advanced Practice Nurses Demonstrates Low Procedural Complication and Infection Rates-A Report From 13 Years of Service.
To report procedural characteristics and outcomes from a central venous catheter placement service operated by advanced practice nurses. ⋯ This report has demonstrated low complication rates for a hospital-wide service delivered by advance practice nurses. The results suggest that a centrally based service with specifically trained operators can be beneficial by potentially improving patient safety and promoting organizational efficiencies.
-
Critical care medicine · Mar 2014
Mice Lacking the Lectin-Like Domain of Thrombomodulin Are Protected Against Melioidosis.
Thrombomodulin is a multidomain receptor primarily expressed by vascular endothelium. The lectin-like domain of thrombomodulin has anti-inflammatory properties. In this study, we investigated the role of the thrombomodulin lectin-like domain in the host response to Gram-negative sepsis caused by Burkholderia pseudomallei, a "Tier 1" biothreat agent and the causative agent of melioidosis, a common form of community-acquired sepsis in Southeast Asia. ⋯ This study reveals for the first time a detrimental role for the thrombomodulin lectin-like domain in the host response to sepsis caused by a clinically relevant Gram-negative pathogen.