Critical care medicine
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Critical care medicine · Jan 2010
Review Meta AnalysisAssociation between tumor necrosis factor-alpha promoter -308 A/G polymorphism and susceptibility to sepsis and sepsis mortality: a systematic review and meta-analysis.
The tumor necrosis factor (TNF)-alpha promoter -308 A/G polymorphism has been reported to be associated with sepsis with inconsistent results. We conducted a systematic review and meta-analysis to determine whether the TNF-alpha -308 A/G polymorphism TNF2 (G/A or A/A) confers susceptibility to sepsis or is associated with increased risk of death from sepsis. ⋯ Our systematic review and meta-analysis demonstrates that the TNF2 polymorphism is associated with sepsis. However, TNF2 is not associated with sepsis mortality.
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Critical care medicine · Jan 2010
Randomized Controlled Trial Multicenter StudyA multicenter, randomized trial of noninvasive ventilation with helium-oxygen mixture in exacerbations of chronic obstructive lung disease.
To assess the effect of a helium-oxygen mixture on intubation rate and clinical outcomes during noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease. ⋯ Despite small trends favoring helium, this study did not show a statistical superiority of using helium during NIV to decrease the intubation rate in acute exacerbation of chronic obstructive pulmonary disease.
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Critical care medicine · Jan 2010
Multicenter Study Comparative StudyIs there an association between nosocomial infection rates and bacterial cross transmissions?
Surveillance data of nosocomial infection rates are increasingly used for public reporting and interhospital comparisons. Approximately 15% of nosocomial infections on intensive care units are the result of patient-to-patient transmissions of the causative organisms. These exogenous infections could be prevented by adherence to basic infection control measures. The association between bacterial cross transmissions and nosocomial infection rates was analyzed. ⋯ Differences in nosocomial infection rates between study intensive care units are not explained solely by cross transmissions. Other factors, like the severity of the patient's underlying diseases, the patient's endogenous flora, or invasive procedures, likely have a dominant effect on the magnitude of nosocomial infection rates.
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Critical care medicine · Jan 2010
Comparative StudyAntiplatelet drugs and outcome in mixed admissions to an intensive care unit.
Platelet activation has been implicated in microvascular thrombosis and organ failure. We tested the hypothesis that antiplatelet drugs favorably affect outcome in patients nonelectively admitted to an intensive care unit. ⋯ Our data are consistent with prevention of organ dysfunction by antiplatelet drugs, which may be masked in some patients by concomitant bleeding risk. Antiplatelet drugs might offer a novel therapeutic option to prevent organ failure, at least in the absence of active bleeding. This hypothesis warrants testing in a prospective trial.
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Critical care medicine · Jan 2010
Comparative StudyAdministration of human protein C improves survival in an experimental model of sepsis.
Study the effect of human protein C (PC) concentrate administration on organ damage and survival in septic rats. ⋯ Human Protein C administration increased survival in septic rats, decreased plasma inflammatory cytokines levels and tissue injury in vital organs.