Crit Care Resusc
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The systemic inflammatory response syndrome (SIRS) concept lacks sensitivity and specificity for guiding clinical practice and sepsis research. ⋯ Both SIRS and weighted SIRS score had low predictive ability for microbiologically confirmed infection. A more robust conceptual framework incorporating clinical, biochemical and immunological markers must be formulated and validated to better guide clinical practice and research. Clinicians' suspicions may be as good as any scoring system at identifying patients with infection and sepsis.
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To measure and describe the extent and consequences of documented medical patient reviews in the 24 hours before a cardiac arrest, medical emergency team (MET) call or an unanticipated intensive care unit admission ("event"), and the use of such reviews as a rapid response system performance measure. ⋯ Medical reviews in the 24 hours before an adverse event are common. The type of medical review may influence patient outcome and thus may be a useful measure of rapid-response systems and critical care performance.
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Review Meta Analysis
The effect of antipyretic medications on mortality in critically ill patients with infection: a systematic review and meta-analysis.
Antipyretic medications are widely used in critically ill patients with infection despite evidence supporting a protective, adaptive role of fever. ⋯ The studies included in this review were insufficient to allow a robust estimate of the effect of pharmacological antipyresis on mortality in critically ill patients with suspected infection. Further RCTs are required to resolve this important area of clinical uncertainty.