Critical care medicine
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Critical care medicine · Jun 2014
Multicenter Study Observational StudyArterial Blood Gas Tensions After Resuscitation From Out-of-Hospital Cardiac Arrest: Associations With Long-Term Neurological Outcome.
In patients resuscitated after out-of-hospital cardiac arrest, mean 24 hour PaCO2 predicted good outcome, specifically time spent with PaCO2 > 45 mmHg. No similar associations could be found between mean 24 h PaO2 and outcome.
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Critical care medicine · Jun 2014
Multicenter Study Observational StudyImpact of Therapeutic Strategies on the Prognosis of Candidemia in the ICU.
To determine the epidemiology of Candida bloodstream infections, variables influencing mortality, and antifungal resistance rates in ICUs in Spain. ⋯ Candidemia in ICU patients is caused by non-albicans species in 48% of cases, C. parapsilosis being the most common among these. Overall mortality remains high and mainly related with host factors. Prompt adequate antifungal treatment and catheter removal could be critical to decrease early mortality.
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Critical care medicine · Jun 2014
Multicenter Study Clinical TrialCorticosteroids and Transition to Delirium in Patients With Acute Lung Injury.
Delirium is common in mechanically ventilated patients in the ICU and associated with short- and long-term morbidity and mortality. The use of systemic corticosteroids is also common in the ICU. Outside the ICU setting, corticosteroids are a recognized risk factor for delirium, but their relationship with delirium in critically ill patients has not been fully evaluated. We hypothesized that systemic corticosteroid administration would be associated with a transition to delirium in mechanically ventilated patients with acute lung injury. ⋯ After adjusting for other risk factors, systemic corticosteroid administration is significantly associated with transitioning to delirium from a nondelirious state. The risk of delirium should be considered when deciding about the use of systemic corticosteroids in critically ill patients with acute lung injury.
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Critical care medicine · Jun 2014
Multicenter StudyTraumatic Injury, Early Gene Expression, and Gram-Negative Bacteremia.
Bacteremic trauma victims have a higher risk of death than their nonbacteremic counterparts. The role that altered immunity plays in the development of bacteremia is unknown. Using an existing dataset, we sought to determine if differences in early postinjury immune-related gene expression are associated with subsequent Gram-negative bacteremia. ⋯ By 96 hours after injury, there are differences in leukocyte gene expression associated with the development of Gram-negative bacteremia, reflecting suppression of both innate and adaptive immunity. Gram-negative bacteremia after trauma is, in part, consequence of host immunity failure and may not be completely preventable by standard infection-control techniques.