Critical care medicine
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Critical care medicine · Aug 2013
Randomized Controlled Trial Multicenter StudyEarly goal-directed sedation versus standard sedation in mechanically ventilated critically ill patients: a pilot study*.
To assess the feasibility and safety of delivering early goal-directed sedation compared with standard sedation. ⋯ Delivery of early goal-directed sedation was feasible, appeared safe, achieved early light sedation, minimized benzodiazepines and propofol, and decreased the need for physical restraints. The findings of this pilot study justify further investigation of early goal-directed sedation.
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Critical care medicine · Aug 2013
ReviewIn silico modeling: methods and applications to trauma and sepsis.
To familiarize clinicians with advances in computational disease modeling applied to trauma and sepsis. ⋯ Computational modeling of inflammation and organ dysfunction at the cellular, organ, whole-organism, and population levels has suggested a positive feedback cycle of inflammation → damage → inflammation that manifests via organ-specific inflammatory switching networks. This structure may manifest as multicompartment "tipping points" that drive multiple organ dysfunction. This process may be amenable to rational inflammation reprogramming.
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Critical care medicine · Aug 2013
Multicenter StudyAcute respiratory distress syndrome after spontaneous intracerebral hemorrhage*.
Acute respiratory distress syndrome develops commonly in critically ill patients in response to an injurious stimulus. The prevalence and risk factors for development of acute respiratory distress syndrome after spontaneous intracerebral hemorrhage have not been reported. We sought to determine the prevalence of acute respiratory distress syndrome after intracerebral hemorrhage, characterize risk factors for its development, and assess its impact on patient outcomes. ⋯ Development of acute respiratory distress syndrome is common after intubation for intracerebral hemorrhage. Modifiable risk factors, including high tidal volume ventilation, are associated with its development and in-patient mortality.
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Critical care medicine · Aug 2013
Randomized Controlled Trial Multicenter StudyEffect of a multifaceted performance feedback strategy on length of stay compared with benchmark reports alone: a cluster randomized trial in intensive care*.
To assess the impact of applying a multifaceted activating performance feedback strategy on intensive care patient outcomes compared with passively receiving benchmark reports. ⋯ In the context of ICUs participating in a national registry, applying a multifaceted activating performance feedback strategy did not lead to better patient outcomes than only receiving periodical registry reports.