Critical care medicine
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Critical care medicine · Feb 2012
Editorial CommentThe intensive care unit continuum of care: easing death.
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Critical care medicine · Feb 2012
Randomized Controlled Trial Multicenter Study Comparative StudyEarly use of noninvasive positive pressure ventilation for acute lung injury: a multicenter randomized controlled trial.
Noninvasive positive pressure ventilation is beneficial for patients with acute respiratory failure. However, its possible benefit for patients with acute lung injury (200 mm Hg < PaO(2)/FIO(2) ≤300 mm Hg) remains unclear. Our aim was to assess the safety and efficacy of noninvasive positive pressure ventilation for patients with acute lung injury and compare this with high-concentration oxygen therapy. ⋯ Noninvasive positive pressure ventilation is safe for selected patients with acute lung injury. However, a larger randomized trial with need for intubation and mortality as the outcomes of interest is required.
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Critical care medicine · Feb 2012
Multicenter Study Comparative StudyZero risk for central line-associated bloodstream infection: are we there yet?.
Identify the longest period a central line remains free from central line-associated bloodstream infection during an 18-month insertion-bundle project. ⋯ The success of the insertion bundle was identified by improved analysis that identified that the safest dwell time was extended to the first 9 days for centrally inserted lines and up to day 7 for dialysis, peripherally inserted central catheters, and unspecified central line types. Given that three quarters of intensive care unit patients have their central line removed by day 7, zero risk for central line-associated bloodstream infection should be achievable in the majority of patients where clinicians comply with the clinician and patient insertion bundles.