Journal of critical care
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Journal of critical care · Sep 2005
ReviewStruggle for implementation of new strategies in intensive care medicine: anticoagulation, insulin, and lower tidal volumes.
The management of intensive care patients have changed dramatically in the last years: from merely supportive care, it has moved to evidence-based strategies that have been demonstrated to reduce mortality of the severely ill patients. Clinical research have brought numerous positive clinical trials offering intensive care physicians specific therapies to improve outcome of intensive care patients. ⋯ Although results of these trials were sufficiently strong to, at least, consider implementation of these strategies in critical care medicine, published and yet unpublished reports show that there is significant struggle with implementation of these therapies. This manuscript focuses on the potential reasons that underlie this problem.
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Journal of critical care · Sep 2005
Meta AnalysisCost-effectiveness of immunoglobulin M-enriched immunoglobulin (Pentaglobin) in the treatment of severe sepsis and septic shock.
To measure the cost-effectiveness of a specific polyclonal intravenous immune globulin preparation (Pentaglobin) in adult patients treated for severe sepsis and septic shock. ⋯ Pentaglobin is a promising adjuvant therapy both clinically and economically for treatment of adults with severe sepsis and septic shock.
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Journal of critical care · Sep 2005
Multicenter StudyThe reliability and validity of the therapeutic activity index.
To assess the psychometric properties of the Simplified Therapeutic Intervention Scoring System (TISS 28) scale. ⋯ Although the findings supported the validity and reliability of the TISS 28, there were limitations of the TISS 28 in measuring nursing workload in ICUs. Hence, continued amendment and validation of the TISS 28 on larger samples in different ICUs would be required so as to provide clinical nurses with a valid and reliable assessment of nursing workload.
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Journal of critical care · Sep 2005
Multicenter StudyPrognosis factors and outcome of community-acquired pneumonia needing mechanical ventilation.
To evaluate the variables associated with mortality of patients with community-acquired pneumonia who require mechanical ventilation and to determine the attributable morbidity and intensive care unit (ICU) mortality of community-acquired pneumonia. ⋯ Community-acquired pneumonia needing mechanical ventilation is not a disease associated with higher mortality. The main determinants of patient outcome were initial severity of illness and the development of shock and/or acute renal failure.
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Journal of critical care · Sep 2005
Incidence of acute respiratory distress syndrome and its relation to age.
The incidence of acute respiratory distress syndrome (ARDS) was previously considered to be relatively low, at less than 10 cases per 100,000 inhabitants per year, but recent reports suggest a higher incidence, especially in elderly patients. The objective was to determine the incidence and mortality of ARDS in our setting, both overall and by age group. ⋯ The incidence of ARDS is higher than reported a decade ago and is especially elevated in the elderly. The mortality remains high.