Critical care medicine
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The objective of this study was to determine the characteristics and survival rates of patients receiving cardiopulmonary resuscitation more than once during a single hospitalization. ⋯ Undergoing multiple cardiopulmonary resuscitation events during a hospitalization is associated with substantially reduced short- and long-term survival compared with patients who undergo cardiopulmonary resuscitation once. This information may be useful to clinicians when discussing end-of-life care with patients and families of patients who have experienced return of spontaneous circulation following in-hospital cardiopulmonary resuscitation but remain at risk for recurrent cardiac arrest.
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Critical care medicine · Jan 2014
Preliminary Report on Cardiac Dysfunction After Isolated Traumatic Brain Injury.
The aim of this study was to examine cardiac dysfunction during the first 2 weeks after isolated traumatic brain injury and its association with in-hospital mortality. ⋯ Cardiac dysfunction in the setting of isolated traumatic brain injury occurs and is associated with increased in-hospital mortality. This finding raises the question as to whether there are uncharted opportunities for a more timely recognition of cardiac dysfunction and subsequent optimization of the hemodynamic management of these patients.
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Critical care medicine · Jan 2014
Renal Histopathology During Experimental Septic Acute Kidney Injury and Recovery.
Our understanding of septic acute kidney injury is limited. We therefore assessed renal histopathological changes induced by septic acute kidney injury and their evolution during recovery. ⋯ The lack of any tubular injury or increased apoptosis, the increased expression of all cortical nitric oxide synthase isoforms, and the link between inducible nitric oxide synthase and neuronal nitric oxide synthase with renal blood flow suggest in this experimental model that severe sepsis acute kidney injury can develop in the absence of histological or immunohistological changes and may be functional in nature.
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Critical care medicine · Jan 2014
Acute Respiratory Failure in Patients With Toxic Epidermal Necrolysis: Clinical Features and Factors Associated With Mechanical Ventilation.
Stevens-Johnson syndrome and toxic epidermal necrolysis are severe adverse cutaneous drug reactions characterized by widespread skin and mucous membrane detachments, including bronchial mucosa, which may be associated with respiratory failure requiring mechanical ventilation. The presentation and outcome of patients requiring mechanical ventilation and the characteristics of bronchial epithelial lesions among ventilated patients are reported. Predictors of mechanical ventilation available on hospital admission were identified using univariate and multivariate logistic regressions. ⋯ Mechanical ventilation is required in one of four Stevens-Johnson syndrome/toxic epidermal necrolysis patients and is associated with a poor outcome. Prompt identification of Stevens-Johnson syndrome/toxic epidermal necrolysis patients at higher risk of intubation could help guide their early management, particularly for those having bronchial epithelial lesions.
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Critical care medicine · Jan 2014
Risk of Developing Pneumonia Is Enhanced by the Combined Traits of Fluoroquinolone Resistance and Type III Secretion Virulence in Respiratory Isolates of Pseudomonas aeruginosa.
To determine the differential association of host characteristics, antimicrobial resistance, and type III secretion system virulence of Pseudomonas aeruginosa isolates with respiratory syndromes in hospitalized adult patients. ⋯ These results suggest that fluoroquinolone-resistant phenotype in a type III secretion system exoU strain background contributes toward the pathogenesis of P. aeruginosa in pneumonia.