Hospital practice (1995)
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Since the onset of the 2009 influenza A (H1N1) pandemic, the virus has caused significant morbidity and mortality. Most cases of 2009 H1N1 have presented as mild febrile illnesses with cough, sore throat, and occasional gastrointestinal symptoms. Dyspnea has been more commonly associated with the onset of severe pulmonary disease. ⋯ Compared with prior influenza seasons, the need for rescue oxygenation therapy with nitric oxide, prone ventilation, high-frequency oscillation, and extracorporeal membrane oxygenation has increased. Specific medical care with neuraminidase inhibitors and antibiotics for secondary bacterial pneumonia are the mainstays of therapy. With optimal care, mortality rates range from 5% to 7% among those hospitalized and reach approximately 20% among those admitted to the intensive care unit.
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Hospital practice (1995) · Apr 2010
ReviewPractice implications of recent clinical trials for the prevention of acute kidney injury in cardiovascular surgery.
Acute kidney injury in patients undergoing cardiovascular surgery is a complex problem with associated increased risks for dialysis, short- and long-term mortality, and progression to end-stage renal disease. Interventions to prevent and treat renal complications in this cohort have seldom been uniformly satisfactory due to the differences in strategies for intervention, drug doses and duration of treatment, baseline renal functions, and population studied. Nonetheless, significant advances have been made and include recognition of the effect of preexisting organ dysfunction on renal outcomes, reassessment of existing therapeutic interventions, and exploration of the feasibility of newer agents to prevent and treat acute kidney injury in cardiovascular surgery patients. This article briefly reviews several of these issues with an emphasis on recent clinical trials in this cohort.