Journal of critical care
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Journal of critical care · Aug 2018
Sepsis in tropical regions: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
Sepsis and septic shock in the tropics are caused by a wide array of organisms. These infections are encountered mainly in low and middle-income countries (LMIC) where a lack of infrastructure and medical facilities contribute to the high morbidity and mortality. Published sepsis guidelines are based on studies primarily performed in high income countries and as such recommendations may or may not be relevant to practice in the tropics. ⋯ Access to rapid, low-cost, and accurate diagnostic tests is critical in countries where tropical diseases are prevalent to facilitate early diagnosis and treatment. Implementation of performance improvement programs may improve outcomes for patients with sepsis and the addition of resuscitation and treatment bundles may further reduce mortality. Associated co-morbidities such as malnutrition and HIV influence outcomes and must be considered.
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Journal of critical care · Aug 2018
Multicenter StudyLate organ failures in patients with prolonged intensive care unit stays.
The purpose of this study was to characterize the organ failures that develop among patients with prolonged ICU stays, defined as those who spent a minimum of 14 days in an ICU. ⋯ Strategies aiming to reduce the development of new late organ failures may be a novel target for preventing persistent critical illness.
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Journal of critical care · Aug 2018
Multicenter StudyVariation in mortality rates after admission to long-term acute care hospitals for ventilator weaning.
We sought to examine variation in long-term acute care hospital (LTACH) quality based on 90-day in-hospital mortality for patients admitted for weaning from mechanical ventilation. ⋯ LTACHs vary widely in mortality rates, underscoring the need to better understand the sources of this variation and improve the quality of care for patients requiring long-term ventilator weaning.
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Journal of critical care · Aug 2018
ReviewZika virus: Report from the task force on tropical diseases by the world Federation of Societies of intensive and critical care medicine.
Zika fever is an acute infectious disease caused by the Zika virus (ZIKV), an RNA virus belonging to the genus Flavivirus. ZIKV can be transmitted by bites from Aedes aegypti and Aedes albopictus species, sexual activity, blood transfusion and from mother to fetus during pregnancy and delivery. A total of 50 territories and countries in the Americas had reported ZIKV infections. ⋯ The most appropriate therapy for ZIKV-associated GBS is yet unclear, however intravenous immunoglobulins have been used, as in conventional GBS. ZIKV infection can be prevented through the use of mosquito repellents, protection with long-sleeved clothing and trousers, and the use of clothes impregnated with permethrin. This review describes the current concepts regarding the epidemiology, diagnosis, clinical manifestations and neurological complications of ZIKV infection.
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Journal of critical care · Aug 2018
Comparative Study Observational StudyComparison of traditional microbiological culture and 16S polymerase chain reaction analyses for identification of preoperative airway colonization for patients undergoing lung resection.
Preoperative airway colonization is associated with increased risk of postoperative respiratory complications following lung resection. This study compares the rates of preoperative lower respiratory tract colonization identified by traditional culture and novel 16S polymerase chain reaction (PCR) tests. ⋯ Rates of colonization identified by culture and 16S PCR analyses of BAL samples were similar. Future research should attempt to clarify associations between airway colonization identified by 16S PCR and outcomes. 16S PCR may be useful when stratifying risk of postoperative respiratory complications.