Journal of critical care
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Journal of critical care · Sep 2002
Comparative StudyDo isolation rooms reduce the rate of nosocomial infections in the pediatric intensive care unit?
To determine the effect of isolation rooms on the direct spread of nosocomial infections (NIs) owing to cross-colonization in a pediatric intensive care unit (PICU). ⋯ Our preliminary analysis suggests a possible beneficial effect of single isolation rooms in reducing NI rate in the PICU. Hence, the influence of room isolation on NIs in pediatric intensive care warrants further investigation.
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Journal of critical care · Sep 2002
Multicenter StudyPrevention of ventilator-associated pneumonia: current practice in Canadian intensive care units.
To evaluate the current use of strategies to prevent ventilator-associated pneumonia (VAP) and to identify interventions to target for quality-improvement initiatives. ⋯ Significant opportunities exist to improve VAP prevention practices in Canada. These strategies include decreasing the frequency of ventilator circuit changes, and increasing the use of non-invasive ventilation, subglottic secretion drainage endotracheal tubes, kinetic bed therapy, small bowel feedings, and elevation of the head of the bed.
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Journal of critical care · Sep 2002
The simultaneous measurement of ionized and total calcium and ionized and total magnesium in intensive care unit patients.
This study was undertaken to determine the relationship between total magnesium and ionized magnesium in critically ill and injured patients. ⋯ Based on our results we would recommend that intensivists directly measure ionized calcium whereas ionized magnesium can be inferred from total magnesium.
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Journal of critical care · Sep 2002
Blood pH level modulates organ metabolism of lactate in septic shock in dogs.
Lactic acidosis is an important complication of septic shock. Alkali treatment such as sodium bicarbonate is often used to treat the low pH level that develops in sepsis. The effect of this treatment on lactate (Lac) clearance is not clear. In the present study, the objective was to examine whether blood pH level alters Lac metabolism in sepsis. Measurements were determined in a canine model of Escherichia coli sepsis after bolus infusion (5 mmol/kg) of either lactic acid (LA) or sodium lactate (NaL). In one preparation, Lac uptake by the splanchnic organs (SP), liver, lung, kidneys (Kid), and soft tissues of the lower extremity (SOL) was primarily determined, whereas in another preparation, Lac uptake by the head and neck region and lung was obtained. ⋯ Lactate clearance was reduced in sepsis. Both effects of pH level and sepsis modulated the organ uptake of Lac in septic shock. Only a small amount of the total Lac infused could be accounted for by the organs measured in the present study. This suggests that additional organs may account for lactate removal in sepsis.