American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2011
Multicenter StudyEarly-onset pneumonia after cardiac arrest: characteristics, risk factors and influence on prognosis.
Although frequent, little is known about early-onset pneumonia that occurs in the postresuscitation period. Although induced hypothermia is recommended as a method of improving neurological outcome, its influence on the occurrence of early-onset pneumonia is not well defined. ⋯ After OHCA, therapeutic hypothermia is associated with an increased risk of early-onset pneumonia. This complication was associated with prolonged respiratory support and ICU stay, but did not significantly influence ICU mortality.
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Am. J. Respir. Crit. Care Med. · Nov 2011
Randomized Controlled TrialContinuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients.
Underinflation of the tracheal cuff frequently occurs in critically ill patients and represents a risk factor for microaspiration of contaminated oropharyngeal secretions and gastric contents that plays a major role in the pathogenesis of ventilator-associated pneumonia (VAP). ⋯ Continuous control of P(cuff) is associated with significantly decreased microaspiration of gastric contents in critically ill patients.
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Am. J. Respir. Crit. Care Med. · Nov 2011
Comparative StudyA multisite assessment of the quantitative capabilities of the Xpert MTB/RIF assay.
The Xpert MTB/RIF is an automated molecular test for Mycobacterium tuberculosis that estimates bacterial burden by measuring the threshold-cycle (Ct) of its M. tuberculosis-specific real-time polymerase chain reaction. Bacterial burden is an important biomarker for disease severity, infection control risk, and response to therapy. ⋯ Xpert MTB/RIF quantitation offers a new, standardized approach to measuring bacterial burden in the sputum of patients with tuberculosis.
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Am. J. Respir. Crit. Care Med. · Nov 2011
Comparative StudyPulmonary artery thrombosis during acute chest syndrome in sickle cell disease.
The pathophysiology of acute chest syndrome (ACS) in patients with sickle cell disease is complex, and pulmonary artery thrombosis (PT) may contribute to this complication. ⋯ PT is not a rare event in the context of ACS and seems more likely in patients with higher platelet counts and lower hemolytic rate during ACS. Patients with sickle cell disease presenting with respiratory symptoms suggestive of ACS may benefit from evaluation for PT.