Intensive care medicine
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Intensive care medicine · Nov 2015
Antifungal de-escalation was not associated with adverse outcome in critically ill patients treated for invasive candidiasis: post hoc analyses of the AmarCAND2 study data.
Systemic antifungal therapy (SAT) of invasive candidiasis needs to be initiated immediately upon clinical suspicion. Controversies exist about adequate time and potential harm of antifungal de-escalation (DE) in documented and suspected candidiasis in ICU patients. Our objective was to investigate whether de-escalation within 5 days of antifungal initiation is associated with an increase of the 28-day mortality in SAT-treated non-neutropenic adult ICU patients. ⋯ In non-neutropenic critically ill adult patients with documented or suspected invasive candidiasis, SAT de-escalation within 5 days was not related to increased day-28 mortality but it was associated with decreased SAT consumption. These results suggest for the first time that SAT de-escalation may be safe in these patients.
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Intensive care medicine · Nov 2015
Geographical variation in use of intensive care: a nationwide study.
To examine whether there is geographical variation in the use of intensive care resources in Denmark concerning both intensive care unit (ICU) admission and use of specific interventions. Substantial variation in use of intensive care has been reported between countries and within the US, however, data on geographical variation in use within more homogenous tax-supported health care systems are sparse. ⋯ There was only minimal geographical variation in the use of intensive care admissions and interventions at the regional level in Denmark, but more pronounced variation at the municipality level.
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Intensive care medicine · Nov 2015
Editorial CommentUnplanned extubation: securing the tool of our trade.