Articles: sepsis.
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Critical care medicine · May 2012
Multicenter StudyEvaluating the use of recombinant human activated protein C in adult severe sepsis: results of the Surviving Sepsis Campaign.
The Surviving Sepsis Campaign developed guidelines for the administration of recombinant human activated protein C in adult severe sepsis. However, it is not clear how these impacted clinical practice or patient outcome. ⋯ Recombinant human activated protein C use was associated with a significant improvement in hospital mortality in patients who participated in the Surviving Sepsis Campaign.
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Critical care medicine · May 2012
Multicenter StudyRelationship between neighborhood poverty rate and bloodstream infections in the critically ill.
Poverty is associated with increased risk of chronic illness, but its contribution to bloodstream infections is not well-defined. ⋯ Within the limitations of our study design, increased neighborhood poverty rate, a proxy for decreased socioeconomic status, appears to be associated with risk of bloodstream infection among patients who receive critical care.
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Critical care medicine · Mar 2012
Multicenter StudyTemporal trends in patient characteristics and survival of intensive care admissions with sepsis: a multicenter analysis*.
To estimate in-hospital, 1-yr, and long-term mortality and to assess time trends in incidence and outcomes of sepsis admissions in the intensive care unit. ⋯ Mortality following intensive care unit sepsis admission remains high and is correlated with underlying patients' characteristics, including age, comorbidities, and the number of failing organ systems.
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Nephrol. Dial. Transplant. · Feb 2012
Multicenter Study Comparative StudyA prospective evaluation of urine microscopy in septic and non-septic acute kidney injury.
Sepsis is the most common trigger for acute kidney injury (AKI) in critically ill patients. We sought to determine whether there are unique patterns to urine sediment in septic compared with non-septic AKI. ⋯ Septic AKI is associated with greater urine microscopy evidence of kidney injury compared with non-septic AKI, despite similar severity of AKI. A UMS ≥ 3 correlated with higher uNGAL and was predictive of worsening AKI. Urine microscopy may have a complementary role for discerning septic from non-septic AKI, discriminating severity and predicting worsening AKI in critically ill patients.
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Current drug safety · Feb 2012
Multicenter StudyA multicenter evaluation of the safety of drotrecogin alfa (activated) in patients with baseline bleeding precautions.
We recently reported an increased incidence of serious bleeding events and mortality in patients with baseline bleeding precautions treated with drotrecogin alfa (activated) compared to patients without such precautions. Whether these observations were specific to our single medical campus is unclear. ⋯ The findings of this study were consistent with our prior observations and suggest the risk for serious bleeding events with drotrecogin alfa (activated) may outweigh any potential benefit in patients with baseline bleeding precautions.