Surgical infections
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Surgical infections · Jan 2004
Longitudinal outcomes of intra-abdominal infection complicated by critical illness.
Critically ill surgical patients remain at high risk of adverse outcomes as a result of intra-abdominal infections, including prolonged length of stay, organ dysfunction, and death despite advances in critical care and innovations in management of the peritoneal cavity. We evaluated the causes and consequences of intra-abdominal infections among critically ill surgical patients in a single tertiary-care intensive care unit (ICU) over a decade. ⋯ Although outcomes are improving, generalized peritonitis still causes high organ dysfunction-related mortality among critically ill surgical patients. Further improvements in resuscitation, surgical technique, and pharmacotherapy of severe intra-abdominal infections are needed.
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Surgical infections · Jan 2004
Review Comparative StudyNew strategies to improve outcomes in the surgical intensive care unit.
Over the last half-decade, substantial breakthroughs have taken place in terms of routine therapy of critically ill patients. The combination of these strategies has the potential to result in improvement in the overall outcomes for patients in intensive care units. ⋯ Appropriate incorporation of these strategies into everyday practice will likely result in improvements in the care of critically ill surgical patients.
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Surgical infections · Jan 2004
Review Case ReportsCryptococcal myositis and vasculitis: an unusual necrotizing soft tissue infection.
Cryptococcus neoformans var. neoformans is an opportunistic yeast that typically infects immunocompromised patients. ⋯ Cryptococcal soft tissue infection serves as a marker of disseminated cryptococcosis in immunocompromised hosts. Owing to its rarity as a cause of soft tissue infections, diagnosis is difficult and mortality is high.
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Surgical infections · Jan 2004
Comparative StudyIs ventilator-associated pneumonia in trauma patients an epiphenomenon or a cause of death?
Ventilator-associated pneumonia (VAP) is a common infection among patients in trauma intensive care units (ICUs). It has been suggested by different investigators that VAP is an indicator of injury severity and not necessarily associated with mortality. Crude mortality rates approximating 20% have been reported for trauma patients with VAP. Most studies have involved the most severely injured patients, making it difficult to determine the relative contribution of either VAP or injury severity to death. If VAP is independently associated with mortality, this relationship should be most evident in less severely injured patients. We studied patients with less severe injuries (Injury Severity Score, ISS < 25) to determine the impact of VAP on outcomes. ⋯ Ventilator-associated pneumonia is independently associated with death in less severely injured trauma patients. This demonstrates the need for effective diagnostic techniques so that adequate therapy may be initiated. Prevention of VAP in less severely injured trauma patients should increase survival.