Critical care medicine
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Critical care medicine · May 2017
Review Meta AnalysisAntipyretic Therapy in Critically Ill Septic Patients: A Systematic Review and Meta-Analysis.
This meta-analysis aimed to examine the impact of antipyretic therapy on mortality in critically ill septic adults. ⋯ Antipyretic treatment does not significantly improve 28-day/hospital mortality in adult patients with sepsis.
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Critical care medicine · May 2017
Randomized Controlled Trial Multicenter StudyRandomized Clinical Trial of a Combination of an Inhaled Corticosteroid and Beta Agonist in Patients at Risk of Developing the Acute Respiratory Distress Syndrome.
Effective pharmacologic treatments directly targeting lung injury in patients with the acute respiratory distress syndrome are lacking. Early treatment with inhaled corticosteroids and beta agonists may reduce progression to acute respiratory distress syndrome by reducing lung inflammation and enhancing alveolar fluid clearance. ⋯ Early treatment with inhaled budesonide/formoterol in patients at risk for acute respiratory distress syndrome is feasible and improved oxygenation as assessed by S/F. These results support further study to test the efficacy of inhaled corticosteroids and beta agonists for prevention of acute respiratory distress syndrome.
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Critical care medicine · May 2017
Multicenter Study Observational StudyIncorporating Inflammation into Mortality Risk in Pediatric Acute Respiratory Distress Syndrome.
In pediatric acute respiratory distress syndrome, lung injury is mediated by immune activation and severe inflammation. Therefore, we hypothesized that patients with elevated pro- and anti-inflammatory cytokines would have higher mortality rates and that these biomarkers could improve risk stratification of poor outcomes. ⋯ In pediatric acute respiratory distress syndrome, pro- and anti-inflammatory cytokines are strongly associated with mortality, ICU morbidity, and biochemical evidence of endothelial injury. These cytokines significantly improve the ability of the oxygenation index to discriminate risk of mortality or severe morbidity and may allow for identification and enrollment of high-risk subgroups for future studies.