Journal of critical care
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Journal of critical care · Jun 2019
Review Meta AnalysisWorldwide variation in Pseudomonas associated ventilator associated pneumonia. A meta-regression.
The objective here is to define the extent and possible reasons for geographic variation in Pseudomonas aeruginosa associated with Ventilator Associated Pneumonia (VAP). ⋯ Pseudomonas associated VAP incidence among reports from six geographic regions worldwide varies by less than twofold with some decline by year of publication. Trauma ICU admission is a significant factor underlying variations in incidence of VAP overall but not Pseudomonas associated VAP.
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Journal of critical care · Jun 2019
Review Case ReportsSevere acute respiratory distress syndrome (ARDS) induced by human adenovirus B21: Report on 2 cases and literature review.
Severe pneumonia and ARDS caused by human adenovirus B21 infections (HAdV-B21) is a rare, but a devastating disease with rapid progression to multiorgan failure and death. However, only a few cases were reported so far. Infections appear associated with increased disease severity and higher mortality in infected critically ill patients. ⋯ In conclusion, data on HAdV-B21 infections causing severe pneumonia or ARDS are scarce. Controlled clinical trials on the therapy of adenovirus pneumonia are non existent and thus there is no established therapy so far. ICU physicians should be aware of this potentially devastating disease and further studies are needed.
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Journal of critical care · Jun 2019
ReviewSelecting and evaluating decision-making strategies in the intensive care unit: A systematic review.
Many patients in the Intensive Care Unit (ICU) die after a decision to withhold or withdraw treatment. To ensure that for each patient the appropriate decision is taken, a careful decision-making process is required. This review identifies strategies that can be used to optimize the decision-making process for continuing versus limiting life sustaining treatment of ICU patients. ⋯ The decision-making process in the ICU can be enhanced by frequent family-meetings with predefined topics. Ethical and palliative support is useful in specific situations. These interventions can reduce non-beneficial ICU treatment days.
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Journal of critical care · Jun 2019
Multicenter Study Observational StudyAdherence to fluid resuscitation guidelines and outcomes in patients with septic shock: Reassessing the "one-size-fits-all" approach.
The Surviving Sepsis Campaign and Centers for Medicare and Medicaid Services (CMS) Severe Sepsis and Septic Shock Management Bundle (SEP-1) recommend rapid crystalloid infusion (≥30 mL/kg) for patients with sepsis-induced hypoperfusion or septic shock. We aimed to assess compliance with this recommendation, factors associated with non-compliance, and how compliance relates to mortality. ⋯ These findings question a "one-size-fits-all" approach to fluid administration and performance measures for patients with sepsis.