Critical care medicine
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Critical care medicine · Nov 2002
Multicenter StudyPopulation-based assessment of intensive care unit-acquired bloodstream infections in adults: Incidence, risk factors, and associated mortality rate.
Nosocomial bloodstream infections have been extensively investigated, but relatively few studies have specifically evaluated the epidemiology of intensive care unit-acquired bloodstream infections. The study objective was to define the incidence, risk factors, microbiology, and clinical outcomes of intensive care unit-acquired bloodstream infections. ⋯ One patient in 20 admitted to Calgary Health Region intensive care units acquires bloodstream infection and suffers longer intensive care unit stay and increased mortality rates. In our region, multiple antibiotic-resistant organisms are uncommon causes of bloodstream infections, suggesting that it may be safe to use narrower spectrum empirical treatment regimens than current guidelines recommend.
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Critical care medicine · Nov 2002
ReviewPediatric trauma: postinjury care in the pediatric intensive care unit.
Traumatic injuries occur in > 20 million children each year and are the leading source of death in children over the age of 1 yr. Mechanisms of injury and subsequent therapies for critically injured children are diverse. This review will focus on resources and management strategies for caring for the severely injured child in the pediatric intensive care unit.
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Critical care medicine · Nov 2002
Intravenous iloprost increases mesenteric blood flow in experimental acute nonocclusive mesenteric ischemia.
To evaluate the effect of an intravenously administered synthetic epoprostenol analog, iloprost, in nonocclusive acute mesenteric ischemia induced by cardiac tamponade. ⋯ Iloprost infusion increased SMA blood flow by 60% in this model of nonocclusive mesenteric ischemia (from 168 +/- 41 to 269 +/- 76 mL/min; p <.05). The effect of iloprost infusion was more prominent after the tamponade (422 +/- 87 mL/min in the iloprost group vs. 232 +/- 111 mL/min in the control group; p <.05). Increased mesenteric perfusion decreased intestinal mucosal hypercarbia, leading to improvement of intramucosal pH.
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Critical care medicine · Nov 2002
Multicenter StudyEffect of an education program aimed at reducing the occurrence of ventilator-associated pneumonia.
The purpose of the study was to determine whether an education initiative could decrease the hospital rate of ventilator-associated pneumonia. ⋯ A focused education intervention can dramatically decrease the incidence of ventilator-associated pneumonia. Education programs should be more widely employed for infection control in the intensive care unit setting and can lead to substantial decreases in cost and patient morbidity attributed to hospital-acquired infections.
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Trauma is the leading cause of both morbidity and mortality in the pediatric population, and traumatic injury causes > 50% of all childhood deaths. Significant mortality rates have been reported for children with traumatic brain injury. ⋯ The costs involved in the care of a child with severe traumatic brain injury, extended over that child's lifetime, are significant. It is unfortunate that despite preventive measures, traumatic brain injury remains the major morbidity and mortality factor for children.