Journal of critical care
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Journal of critical care · Feb 2018
ReviewSpatial methods for evaluating critical care and trauma transport: A scoping review.
The objective of this scoping review is to inform future applications of spatial research regarding transportation of critically ill patients. We hypothesized that this review would reveal gaps and limitations in the current research regarding use of spatial methods for critical care and trauma transport research. ⋯ There is a gap between the availability of spatial tools and their usage for analyzing and improving medical transportation. The adoption of geospatially guided transport decisions can meaningfully impact healthcare expenditures, especially in healthcare systems looking to strategically control expenditures with minimum impact on patient outcomes.
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Journal of critical care · Feb 2018
ReviewDengue fever: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
Dengue is an arbovirus affecting humans and spread by mosquitoes. Severe dengue follows a secondary infection with a different virus serotype. The problem is truly global as it is endemic in over 100 countries. ⋯ Commercial rapid tests and ELISA kits are freely available, ensuring early diagnosis. The basis of management of severe dengue is effective fluid replacement. Future directions in management will involve vector control and development of effective vaccination.
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Journal of critical care · Feb 2018
Observational StudyCharacteristics and outcomes of critically-ill medical patients admitted to a tertiary medical center with restricted ICU bed capacity.
In the emergency department (ED) critically-ill medical patients are treated in the resuscitation room (RR). No studies described the outcomes of critically-ill RR patients admitted to a hospital with low capacity of intensive care unit (ICU) beds. ⋯ ED critically-ill medical patients who were treated in the RR had high mortality rates in an institute with restricted ICU beds availability. However, those who were admitted to an ICU showed prolonged short and perhaps long term survival compared to those who were not.
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Journal of critical care · Feb 2018
Observational StudyImpact of antibiotic therapy in severe community-acquired pneumonia: Data from the Infauci study.
Antibiotic therapy (AT) is the cornerstone of the management of severe community-acquired pneumonia (CAP). However, the best treatment strategy is far from being established. To evaluate the impact of different aspects of AT on the outcome of critically ill patients with CAP, we performed a post hoc analysis of all CAP patients enrolled in a prospective, observational, multicentre study. ⋯ Prolonged AT (>7days) was associated with a longer ICU (14 vs. 7days; p<0.001) and hospital length of stay (LOS) (25 vs. 17days; p<0.001). Combination AT with a macrolide may be the most suitable AT strategy to improve both short and long term outcome of severe CAP patients. AT >7days had no survival benefit and was associated with a longer LOS.
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Journal of critical care · Feb 2018
Prior antimicrobial therapy duration influences causative pathogens identification in ventilator-associated pneumonia.
To determine whether prior antimicrobial therapy, divided in recent or current antibiotic treatment, influences the identification rate and/or the type of causative pathogens in patients with suspected episodes of ventilator-acquired pneumonia. ⋯ In patients with a high probability of VAP, current but not recent antibiotic use is associated with a lower rate of positive culture with a higher proportion of MDR pathogens, mostly MDR Pseudomonas aeruginosa.