Journal of critical care
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Journal of critical care · Feb 2016
Impact of bronchoalveolar lavage multiplex polymerase chain reaction on microbiological yield and therapeutic decisions in severe pneumonia in intensive care unit.
The purpose of the study is to evaluate the impact of adding bronchoalveolar lavage multiplex polymerase chain reaction (M-PCR) to conventional cultures (CC) on microbiological yield and therapeutic decisions in adult intensive care unit patients with pneumonia and severe sepsis or septic shock. ⋯ Bronchoalveolar lavage M-PCR with culture leads to higher microbiological yield and earlier modification of antibiotics compared to conventional culture.
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Journal of critical care · Feb 2016
Observational StudyPrognosis of patients presenting extreme acidosis (pH <7) on admission to intensive care unit.
The purpose was to determine prognosis of patients presenting extreme acidosis (pH <7) on admission to the intensive care unit (ICU) and to identify mortality risk factors. ⋯ Patients with extreme acidosis on admission to ICU have a less severe than expected prognosis. Whereas mortality is almost 100% in cases of cardiac arrest before admission, mortality is much lower in the absence of cardiac arrest before admission, which justifies aggressive ICU therapies.
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Journal of critical care · Feb 2016
The role of human metapneumovirus in the critically ill adult patient.
The purpose of the study is to describe the role of human metapneumovirus (hMPV) infection in critical illness and acute respiratory distress syndrome (ARDS). ⋯ Although most patients hospitalized with hMPV had chronic cardiac or pulmonary disease, hMPV can also be associated serious respiratory illness and ARDS in adult patients without significant comorbidities or immunosuppression.
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Journal of critical care · Feb 2016
Risk factor analysis of postoperative acute respiratory distress syndrome in valvular heart surgery.
The aim of this study is to investigate the incidence, severity, and outcome of postoperative acute respiratory distress syndrome (ARDS), according to the Berlin definition, in isolated valvular heart surgery. The preoperative and perioperative predisposing factors of this complication were also identified. ⋯ In conclusion, postoperative ARDS, according to Berlin definition, in valvular surgery, was associated with high in-hospital mortality. The severity of ARDS was associated with patient midterm mortality. In multivariate analysis, age, liver cirrhosis, massive blood transfusion, and tricuspid valve replacement were identified as independent risk factors of ARDS.
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Journal of critical care · Feb 2016
Palliative and end-of-life educational practices in US pulmonary and critical care training programs.
To describe educational features in palliative and end-of-life care (PEOLC) in pulmonary/critical care fellowships and identify the features associated with perceptions of trainee competence in PEOLC. ⋯ This survey of PEOLC education in US pulmonary/critical care fellowships identified associations between certain program features and perceived trainee skill in PEOLC. These results generate hypotheses for further study.