Critical care medicine
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To determine whether a systematic review of the literature could identify changes in the mortality of septic shock over time. ⋯ The present review showed a slight reduction in mortality from septic shock over the years, although this result should be approached with caution. The heterogeneity of the articles and absence of a severity score for most of the studies limited our analysis. Furthermore, there was an increasing prevalence of Gram-positive causative organisms, and a change of the predominant origin of sepsis from the abdomen to the chest.
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Critical care medicine · Dec 1998
Comparative StudyNoninvasive management of pediatric neuromuscular ventilatory failure.
To evaluate the use of mouth piece/nasal intermittent positive-pressure ventilation (IPPV) as an alternative to intubation or to permit extubation for patients with primarily neuromuscular ventilatory impairment and no ventilator-free breathing ability. ⋯ The use of inspiratory and expiratory aids can decrease the need for intubation for patients with neuromuscular ventilatory failure in the absence of significant lung disease. It can also permit extubation, despite the need for continuous ventilatory support and, thereby, decrease the need to resort to tracheostomy.
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Critical care medicine · Dec 1998
Editorial Comment ReviewProne position in acute respiratory distress syndrome: turning over an old idea.