Critical care medicine
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Critical care medicine · Apr 2008
Editorial Comment Randomized Controlled Trial Multicenter Study"The truth, if it exists, is in the details".
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Critical care medicine · Apr 2008
Randomized Controlled Trial Multicenter Study Comparative StudyEfficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator-associated pneumonia: a multicenter, randomized study.
Doripenem is an investigational carbapenem with broad-spectrum activity against gram-negative and gram-positive pathogens, including multidrug-resistant strains, commonly responsible for ventilator-associated pneumonia (VAP). This large, phase III study compared doripenem with imipenem for the treatment of ventilator-associated pneumonia. ⋯ In this large, phase III study of patients with ventilator-associated pneumonia, a 4-hr intravenous infusion of doripenem was clinically efficacious and therapeutically noninferior to imipenem.
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Critical care medicine · Apr 2008
ReviewQuality of professional society guidelines and consensus conference statements in critical care.
To examine the quality of professional society critical care guidelines and consensus statements. ⋯ The overall quality of critical care professional society guidelines and consensus statements, as assessed by three published quality instruments, is low. Although the quality of guidelines seems to be increasing over time, there is room for improvement, which could in turn facilitate knowledge translation and improve patient care in the intensive care unit.
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Critical care medicine · Apr 2008
Gene-expression profiling of gram-positive and gram-negative sepsis in critically ill patients.
It is unclear whether the host response of gram-positive sepsis differs from gram-negative sepsis at a transcriptome level. Using microarray technology, we compared the gene-expression profiles of gram-positive sepsis and gram-negative sepsis in critically ill patients. ⋯ Gram-positive sepsis and gram-negative sepsis share a common host response at a transcriptome level. These findings support the hypothesis that the septic response is nonspecific and is designed to provide a more general response that can be elicited by a wide range of different microorganisms.
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Critical care medicine · Apr 2008
Review Meta AnalysisEffect of dopexamine infusion on mortality following major surgery: individual patient data meta-regression analysis of published clinical trials.
To establish whether perioperative low-dose dopexamine infusion (< or = 1 microg/kg/min) is associated with a reduction in mortality and duration of hospital stay following major surgery. ⋯ For pooled data describing perioperative dopexamine infusion at all doses, there was an improvement in duration of hospital stay but no survival benefit. However, at low doses, dopexamine was associated with improved survival and reduced duration of stay. Further clinical trials are warranted to confirm this observation.