Surgical infections
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Exposure of patients to allogeneic blood transfusion can be minimized or avoided by the systematic use of multiple blood conservation techniques. Current use of these technologies is variable. ⋯ Pharmacologic stimulation of erythropoiesis offers substantial potential to progress toward a goal of bloodless medicine. The potential of artificial blood substitutes is still being defined.
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Surgical infections · Jan 2005
Randomized Controlled TrialThe effect of antipyretic therapy upon outcomes in critically ill patients: a randomized, prospective study.
Despite the large body of evidence suggesting a beneficial role of fever in the host response, antipyretic therapy is commonly employed for febrile critically ill patients. Our objective was to evaluate the impact of antipyretic therapy strategies on the outcomes of critically ill patients. ⋯ Aggressively treating fever in critically ill patients may lead to a higher mortality rate.
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Surgical infections · Jan 2005
ReviewClinical challenges and unmet needs in the management of complicated skin and skin structure, and soft tissue infections.
Skin and soft tissue infections remain among the most frequently encountered infections in surgery, and their severity ranges from mild cellulitis to severe, necrotizing infections with high incidences of morbidity and mortality. Most commonly, these disorders result from skin lesions in a susceptible host, but sometimes develop following hematogenous spread from a previously unknown focus. ⋯ New, promising agents, with activity against multi-drug resistant gram-positive and gram-negative organisms, are aimed at filling the gap in the treatment of complicated skin and skin-structure infections.
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Surgical infections · Jan 2005
Improving timely surgical antibiotic prophylaxis redosing administration using computerized record prompts.
Timely prophylactic antibiotic administration aids in preventing postoperative superficial surgical site infections. However, during lengthy surgical procedures, redosing of prophylactic antibiotics may be unintentionally omitted. We assessed the utility of a computerized reminder as part of the anesthesia charting system to increase the rate of timely intraoperative prophylactic antibiotic redosing. ⋯ A computerized reminder system is an effective tool to assist in appropriate intraoperative redosing of prophylactic antibiotics during lengthy surgical procedures.
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Anemia is a common complication of critical illness. Because tissue hypoxia is a prominent factor in the development of organ dysfunction in the critically ill, conventional wisdom has argued that the transfusion of packed red blood cells can attenuate tissue hypoxia and so improve outcome. ⋯ A conservative transfusion strategy appears safe in nearly all critically ill patients without active hemorrhage, including patients with cardiovascular disease. Whether a lower transfusion threshold could be adopted is unknown.