Critical care medicine
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Critical care medicine · Feb 2013
Deceased organ donation consent rates among racial and ethnic minorities and older potential donors.
We sought to assess consent rates for organ donation from potential brain-dead donors, and to identify factors associated with variation in consent for donation that could guide the development of targeted interventions to increase organ consent rates. ⋯ In presenting the first published analyses of consent rates among all eligible deaths, this study confirms smaller and regional studies that showed significant differences in consent rates between whites and racial/ethnic minorities (blacks, Hispanics, and Asians). The study also identifies considerable variation in consent rates between age groups and between organ procurement organizations. Critical care physicians are usually the front-line providers for potential brain-dead donors and their next-of-kin, and these data highlight the need for further research to identify the causes of variation in consent rates and mechanisms to increase rates where appropriate.
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Critical care medicine · Feb 2013
A model to create an efficient and equitable admission policy for patients arriving to the cardiothoracic ICU.
To develop queuing and simulation-based models to understand the relationship between ICU bed availability and operating room schedule to maximize the use of critical care resources and minimize case cancellation while providing equity to patients and surgeons. ⋯ Queuing theory and computer simulation can be used to model case flow through a cardiothoracic operating room and ICU. A dynamic admission policy that looks at current waiting time and expected ICU length of stay allows for increased equity between patients with only minimum losses of efficiency. This dynamic admission policy would seem to be a superior in maximizing case-flow. These results may be generalized to other surgical ICUs.
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Critical care medicine · Feb 2013
Effective treatment of mouse sepsis with an inhibitory antibody targeting integrin αvβ5.
Integrin αvβ5 has been identified as a regulator of vascular leak and endothelial permeability. We hypothesized that targeting αvβ5 could represent a viable treatment strategy for sepsis. ⋯ Our studies suggest that αvβ5 is an important regulator of the vascular endothelial leak response in sepsis and that αvβ5 blockade may provide a novel approach to treating this devastating disease syndrome.
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Critical care medicine · Feb 2013
Editorial CommentFailure of noninvasive ventilation: one more chance?