Journal of critical care
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Journal of critical care · Jun 2012
Randomized Controlled Trial Multicenter StudyFluid Resuscitation with 5% albumin versus Normal Saline in Early Septic Shock: a pilot randomized, controlled trial.
Randomized, controlled trials of fluid resuscitation in early septic shock face many logistic challenges. We describe the Fluid Resuscitation with 5% albumin versus Normal Saline in Early Septic Shock (PRECISE) pilot trial study design and report feasibility of patient recruitment. ⋯ Patient recruitment into the PRECISE pilot trial met our prespecified feasibility targets, and the PRECISE team is planning the larger trial.
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Journal of critical care · Jun 2012
Randomized Controlled Trial Comparative StudyThe effects of levosimendan vs dobutamine added to dopamine on liver functions assessed with noninvasive liver function monitoring in patients with septic shock.
Septic shock is the leading causes of death in intensive care units. In addition to generous fluid administration, inotropic agents are commonly used to improve cardiac output. The effects of inotropic agents on regional blood flow remains unknown. ⋯ These results suggest that levosimendan added to dopamine improves systemic hemodynamics and increases splanchnic perfusion assessed using the user-friendly noninvasive bedside system LiMON in patients with septic shock compared with dobutamine.
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Journal of critical care · Jun 2012
Multicenter StudyRisk factors for underuse of lung-protective ventilation in acute lung injury.
We assessed factors associated with underuse of lung-protective ventilation (LPV) in patients with acute lung injury (ALI). ⋯ Simple interventions could substantially improve adherence with LPV among patients with ALI and warrant prospective study.
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Journal of critical care · Jun 2012
Multicenter StudyThe adequacy of timely empiric antibiotic therapy for ventilator-associated pneumonia: an important determinant of outcome.
The individual impact of timeliness vs adequacy of empiric antibiotic therapy for a clinical suspicion of ventilator-associated pneumonia (CSVAP) is unknown. Accordingly, in patients with CSVAP and timely initiation of empiric antibiotic therapy, we determined the impact of inadequate therapy (IT). ⋯ In the context of early administration of empiric broad spectrum antibiotics for CSVAP, IT is associated with higher morbidity and mortality.