Journal of critical care
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Journal of critical care · Dec 2014
Observational StudyVolume of fluids administered during resuscitation for severe sepsis and septic shock and the development of the acute respiratory distress syndrome.
The purpose of this study was to examine the association between the volume of intravenous (IV) fluids administered in the resuscitative phase of severe sepsis and septic shock and the development of the acute respiratory distress syndrome (ARDS). ⋯ For patients hospitalized for severe sepsis and septic shock, fluid administration to improve end-organ perfusion should remain the top priority in early resuscitation despite the potential risk of inducing ARDS.
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Journal of critical care · Dec 2014
Review Meta AnalysisProlonged vs intermittent infusion of piperacillin/tazobactam in critically ill patients: A narrative and systematic review.
The purpose of this study is to review the rationale of prolonged (ie, extended or continuous) infusion of piperacillin/tazobactam (PIP/TAZ) in critically ill patients and to perform a systematic review that compare the effectiveness of prolonged infusion with intermittent bolus of PIP/TAZ. ⋯ Pharmacokinetic/pharmacodynamic studies provide a robust rationale to prefer prolonged above intermittent infusion of PIP/TAZ. However, although some studies suggest a better outcome in critically ill patients receiving prolonged infusion, the level of evidence is moderate.
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Journal of critical care · Dec 2014
Letter ReviewThe shortage of critical care physicians: Is there a solution?
The objective of this study is to provide a solution to the critical care physician shortage. ⋯ Family Practice is the second largest collective group of physicians in the United States-second only to internal medicine. In most of rural America, where there are limited physicians serving the population, family practitioners fill the gap and provide services otherwise unavailable to those patients. This group that can potentially be trained in critical care and help solve the crisis has been prevented from doing so.