Critical care medicine
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Critical care medicine · Jun 1999
Randomized Controlled Trial Clinical TrialFluconazole prophylaxis prevents intra-abdominal candidiasis in high-risk surgical patients.
To evaluate the efficacy and safety of intravenous fluconazole for the prevention of intra-abdominal Candida infections in high-risk surgical patients. ⋯ Fluconazole prophylaxis prevents colonization and invasive intra-abdominal Candida infections in high-risk surgical patients.
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Critical care medicine · Jun 1999
Randomized Controlled Trial Comparative Study Clinical TrialThe ex vivo antimicrobial activity and colonization rate of two antimicrobial-bonded central venous catheters.
Catheter-related sepsis is an important complication associated with the use of central venous catheters. Recent studies have suggested that antimicrobial-bonded catheters may reduce catheter colonization and catheter-related sepsis. The aim of this study was to determine the relationship between the antimicrobial activity and the colonization rate of two commercially available antimicrobial-bonded central venous catheters. ⋯ The Bio-Guard central venous catheter had greater ex vivo antimicrobial activity against MRSA, S. epidermidis, and E. faecalis compared with the ARROWgard catheter, and this was associated with a significantly lower rate of catheter colonization.
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Critical care medicine · Jun 1999
Randomized Controlled Trial Clinical TrialN-Acetylcysteine treatment to prevent the progression of multisystem organ failure: a prospective, randomized, placebo-controlled study.
To investigate whether prolonged infusion of N-acetylcysteine (NAC) that is commenced immediately after admission to the intensive care unit could ameliorate the development or progression of multisystem organ failure and improve mortality. ⋯ We found a nonsignificant difference in outcome between NAC and placebo-treated patients. Our results suggest that the initiation of NAC treatment >24 hrs after hospital admission may potentially be harmful, and further studies should be undertaken to investigate the clinical use of the early application of NAC in critically ill patients.
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Critical care medicine · Jun 1999
Comparative Study Clinical TrialImpaired inducibility of heat shock protein 70 in peripheral blood lymphocytes of patients with severe sepsis.
To determine the extent of the potentially protective heat shock protein 70 response in peripheral blood lymphocytes of patients with severe sepsis after ex vivo lipopolysaccharide stimulation. ⋯ Inducibility of ex vivo heat shock protein 70 was impaired in peripheral blood lymphocytes of patients with severe sepsis. The impaired expression of the potentially protective heat shock protein 70 may contribute in vivo to immune dysfunction, because intact functioning of T and B lymphocyte responses is of central importance in resisting infection in severe sepsis. Monitoring of inducible heat shock protein 70 in peripheral blood lymphocytes may contribute to the evaluation of the immune consequences of severe sepsis.
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Critical care medicine · Jun 1999
Comparative StudyUse of intraosseous blood to assess blood chemistries and hemoglobin during cardiopulmonary resuscitation with drug infusions.
To compare intraosseous with central venous blood samples for biochemical analyses and hemoglobin levels during cardiopulmonary resuscitation (CPR) and during cardiopulmonary resuscitation with infusion of sodium bicarbonate, epinephrine, and saline boluses through the intraosseous site. ⋯ Intraosseous and central venous blood biochemical and hemoglobin values were similar during hemodynamic stability and throughout 30 mins of resuscitation if no drugs were given through the intraosseous site. However, differences existed after 30 mins of CPR and infusions through the intraosseous site. Laboratory values may be erroneous when intraosseous blood is used during periods of resuscitation of >5 mins if drugs and fluid boluses have also been infused through the site. For reliable values, an intraosseous site for sampling only may be reasonable.