Intensive care medicine
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Intensive care medicine · Nov 2014
Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study.
To determine the association between compliance with the Surviving Sepsis Campaign (SSC) performance bundles and mortality. ⋯ This analysis demonstrates that increased compliance with sepsis performance bundles was associated with a 25% relative risk reduction in mortality rate. Every 10% increase in compliance and additional quarter of participation in the SSC initiative was associated with a significant decrease in the odds ratio for hospital mortality. These results demonstrate that performance metrics can drive change in clinical behavior, improve quality of care, and may decrease mortality in patients with severe sepsis and septic shock.
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Intensive care medicine · Nov 2014
The impact of using estimated GFR versus creatinine clearance on the evaluation of recovery from acute kidney injury in the ICU.
To quantify the error in evaluating recovery from acute kidney injury (AKI) with estimated GFR (eGFR) in relation to ICU stay. ⋯ Compared to Clcr, discharge eGFR results in overestimation of renal recovery in patients with prolonged ICU stay and in reduced accuracy of "CKD staging". Since age, gender and race do not change during ICU stay the same conclusion can be drawn with regard to plasma creatinine.
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Intensive care medicine · Nov 2014
Our paper 20 years later: Inhaled nitric oxide for the acute respiratory distress syndrome-discovery, current understanding, and focussed targets of future applications.
More than 20 years have passed since we reported our results of treating patients with the acute respiratory distress syndrome (ARDS) with inhaled nitric oxide (iNO). The main finding was that iNO alleviated pulmonary hypertension (PH) by selective vasodilation of pulmonary vessels in ventilated lung areas. This, in turn, improved arterial oxygenation. ⋯ In summary, the discovery of and research on the many positive effects of iNO has improved care of critically ill patients worldwide. It is a noble effort to continue on this path.