American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2011
Multicenter StudyBurnout in ICU caregivers: a multicenter study of factors associated to centers.
The stressful work environment of ICUs can lead to burnout. Burnout can impact on the welfare and performance of caregivers, and may lead them to resign their job. The shortage of ICU caregivers is becoming a real threat for health care leaders. ⋯ The findings of this study seem to open a new frontier concerning burnout in ICUs, highlighting the importance of team composition. Our results should be confirmed in a prospective multicenter, multinational study. Whether our results can be exported to other medical settings where team-working is pivotal remains to be investigated.
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Am. J. Respir. Crit. Care Med. · Nov 2011
Multicenter StudyAttributable mortality of ventilator-associated pneumonia: a reappraisal using causal analysis.
Measuring the attributable mortality of ventilator-associated pneumonia (VAP) is challenging and prone to different forms of bias. Studies addressing this issue have produced variable and controversial results. ⋯ Our study on the attributable mortality of VAP is the first that simultaneously accounts for the time of acquiring VAP, informative loss to follow-up after ICU discharge, and the existence of complex feedback relations between VAP and the evolution of disease severity. In contrast to the majority of previous reports, we detected a relatively limited attributable ICU mortality of VAP.
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Am. J. Respir. Crit. Care Med. · Nov 2011
Multicenter Study Comparative StudyThe progression of chronic obstructive pulmonary disease is heterogeneous: the experience of the BODE cohort.
Chronic obstructive pulmonary disease (COPD) is thought to result in rapid and progressive loss of lung function usually expressed as mean values for whole cohorts. ⋯ The progression of COPD is very heterogeneous. Most patients show no statistically significant decline of FEV(1) or increase in BODE. The multidimensional evaluation of COPD should offer insight into response to COPD management.
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Am. J. Respir. Crit. Care Med. · Nov 2011
Multicenter StudyEarly-onset pneumonia after cardiac arrest: characteristics, risk factors and influence on prognosis.
Although frequent, little is known about early-onset pneumonia that occurs in the postresuscitation period. Although induced hypothermia is recommended as a method of improving neurological outcome, its influence on the occurrence of early-onset pneumonia is not well defined. ⋯ After OHCA, therapeutic hypothermia is associated with an increased risk of early-onset pneumonia. This complication was associated with prolonged respiratory support and ICU stay, but did not significantly influence ICU mortality.
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Am. J. Respir. Crit. Care Med. · Nov 2011
Multicenter StudyObesity and primary graft dysfunction after lung transplantation: the Lung Transplant Outcomes Group Obesity Study.
Obesity has been linked to acute lung injury and is a risk factor for early mortality after lung transplantation. ⋯ Obesity is an independent risk factor for primary graft dysfunction after lung transplantation.