Critical care medicine
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Critical care medicine · Jan 2006
Editorial Comment Comparative StudyThe Holy Grail of volume resuscitation in the septic patient is...
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Critical care medicine · Jan 2006
Randomized Controlled Trial Multicenter Study Comparative StudyHypercapnic acidosis and mortality in acute lung injury.
We tested the hypothesis that hypercapnic acidosis is associated with reduced mortality rate in patients with acute lung injury independent of changes in mechanical ventilation. ⋯ Hypercapnic acidosis was associated with reduced 28-day mortality in the 12 mL/kg predicted body weight tidal volume group after controlling for comorbidities and severity of lung injury. These results are consistent with a protective effect of hypercapnic acidosis against ventilator-associated lung injury that was not found when the further ongoing injury was reduced by 6 mL/kg predicted body weight tidal volumes.
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Critical care medicine · Jan 2006
Comment Letter Comparative StudyDraining all pleural effusions in the intensive care unit?
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Critical care medicine · Jan 2006
Randomized Controlled Trial Multicenter Study Comparative Study Historical ArticleEffect of low doses of corticosteroids in septic shock patients with or without early acute respiratory distress syndrome.
We investigated the efficacy of low doses of corticosteroids in septic shock patients with or without early acute respiratory distress syndrome (ARDS) by post hoc analysis of a previously completed clinical trial. ⋯ This post hoc analysis shows that a 7-day treatment with low doses of corticosteroids was associated with better outcomes in septic shock-associated early ARDS nonresponders, but not in responders and not in septic shock patients without ARDS.
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Critical care medicine · Jan 2006
Review Comparative StudyIntensive care unit quality improvement: a "how-to" guide for the interdisciplinary team.
Quality improvement is an important activity for all members of the interdisciplinary critical care team. Although an increasing number of resources are available to guide clinicians, quality improvement activities can be overwhelming. Therefore, the Society of Critical Care Medicine charged this Outcomes Task Force with creating a "how-to" guide that focuses on critical care, summarizes key concepts, and outlines a practical approach to the development, implementation, evaluation, and maintenance of an interdisciplinary quality improvement program in the intensive care unit. ⋯ This Society of Critical Care Medicine Task Force report provides an overview for clinicians interested in developing or improving a quality improvement program using a step-wise approach. Success depends not only on committed interdisciplinary work that is incremental and continuous but also on strong leadership. Further research is needed to refine the methods and identify the most cost-effective means of improving the quality of health care received by critically ill patients and their families.