Intensive care medicine
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Intensive care medicine · Mar 2009
Mortality in ICU patients with bacterial community-acquired pneumonia: when antibiotics are not enough.
It remains uncertain why immunocompetent patients with bacterial community-acquired pneumonia (CAP) die, in spite of adequate antibiotics. ⋯ Mortality remains unacceptably high in immunocompetent patients admitted to the ICU with bacterial pneumonia, despite adequate initial antibiotics and comorbidities management. Patients with shock, acute renal failure and APACHE II score higher than 24 should be considered for inclusion in trials of adjunctive therapy in order to improve CAP survival.
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Intensive care medicine · Mar 2009
Transfusion practices for acute traumatic brain injury: a survey of physicians at US trauma centers.
To determine whether physician specialty influences transfusion threshold in patients with acute severe traumatic brain injury (TBI). ⋯ Neurosurgeons prefer more liberal transfusion of TBI patients than TS and CC, suggesting that actual practice may depend largely on which specialist is primarily managing care. The observed clinical equipoise would justify a randomized trial of liberal versus restrictive transfusion strategies in patients with TBI.
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Intensive care medicine · Mar 2009
A national analysis of the relationship between hospital factors and post-cardiac arrest mortality.
We sought to generate national estimates for post-cardiac arrest mortality, to assess trends, and to identify hospital factors associated with survival. ⋯ Mortality after in-hospital cardiac arrest decreased over 5 years. Mortality was lower at urban, teaching, and large hospitals. There are implications for dissemination of best practices or regionalization of post-cardiac arrest care.