Current opinion in critical care
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Infections remain an important threat for critically ill patients, and the emergence of antibiotic resistance is increasingly hampering successful treatment. In this review, new aspects of the diagnosis and prevention of ventilator-associated pneumonia and of strategies of antibiotic use to limit the development and spread of resistance are described. ⋯ Recent developments in diagnosis, treatment, and prevention of ventilator-associated pneumonia and strategies to reduce emergence of antibiotic resistance have been reviewed. Whether changes in antibiotic policy will reduce the emergence of antibiotic resistance remains to be determined. In this area, methodologic problems that have been overlooked in many studies have been addressed recently. These issues must be clarified to provide reliable data on the effects of interventions in hospital settings.
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Curr Opin Crit Care · Oct 2004
ReviewSimulation in critical care and trauma education and training.
To review theory and practice of simulation technology in critical care and trauma training. ⋯ Simulation appears poised to revolutionize education, training, and credentialing in critical care, surgery, and anesthesiology. However, advances in computing and technology have outpaced the evaluative and validation studies of simulation-based education.
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Curr Opin Crit Care · Oct 2004
ReviewInflammation and cardiovascular diseases: lessons that can be learned for the patient with cardiogenic shock in the intensive care unit.
In the past 12 years, atherosclerosis and the acute coronary syndromes have turned out to be thromboinflammatory diseases. Recent data suggest that inflammation also plays an important role in the pathogenesis and outcome of cardiogenic shock. This review will summarize recent advances in the understanding of the pathophysiology of cardiogenic shock related to the inflammatory network and will discuss recent findings in the treatment of patients with cardiogenic shock in relation to these new insights. ⋯ The promising results of studies that tested a potential benefit of drugs with clear or potential antiinflammatory/immunomodulatory properties in patients with cardiogenic shock underscores the importance of the inflammatory network in the pathogenesis and outcome of this devastating complication of cardiovascular disease.
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Curr Opin Crit Care · Oct 2004
ReviewAdvances in statistical methodology and their application in critical care.
To review some of the major advances in statistical methodology of the past two decades and their application to investigations in critical care. ⋯ By becoming familiar with advances in statistical methodology, researchers and clinicians can enhance collaboration with their statistical colleagues, toward the goal of better study design and analysis.