Articles: sepsis.
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Nosocomial bloodstream infections occur at a rate of 1.3 to 14.5 per 1000 hospital admissions and are believed to lead directly to 62,500 deaths per year in the United States. Measures of the incidence and the proportion of all hospital deaths related to deaths from these infections provide estimates of their impact. The objectives of the study were to characterize the secular trends in nosocomial bloodstream infection at a single institution and to estimate the population-attributable risk for death among patients experiencing the infection. ⋯ The incidence, the etiologic fraction, and the population-attributable risk for death among patients experiencing nosocomial bloodstream infections increased progressively during the last decade.
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Critical care medicine · Jun 1995
Randomized Controlled Trial Clinical TrialFrequency of mortality and myocardial infarction during maximizing oxygen delivery: a prospective, randomized trial.
To determine the frequency of myocardial infarction and mortality during treatment that increased oxygen delivery (DO2) to > or = 600 mL/min/m2. To define the characteristics of patients achieving a high DO2 without inotropes in order to guide future studies. ⋯ The group that required catecholamines to achieve a DO2 of > or = 600 mL/min/m2 had a lower mortality rate, with no increase in the frequency of myocardial infarction. Future prospective, controlled trials examining select groups of patients (age > or = 50 yrs) may demonstrate a difference between control and treatment groups by eliminating the majority of patients who generate the high DO2 with only preload augmentation.
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We performed this investigation to assess whether selective approaches to performing lumbar puncture (LP) in the early neonatal period will result in a missed or delayed diagnosis of bacterial meningitis. ⋯ If LPs are omitted as part of the early neonatal sepsis evaluation, the diagnosis of bacterial meningitis occasionally will be delayed or missed completely.
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Critical care medicine · Jun 1995
Randomized Controlled Trial Multicenter Study Clinical TrialA second large controlled clinical study of E5, a monoclonal antibody to endotoxin: results of a prospective, multicenter, randomized, controlled trial. The E5 Sepsis Study Group.
To evaluate the safety and efficacy of E5, a murine, monoclonal antibody directed against endotoxin, in the treatment of patients with Gram-negative sepsis. ⋯ In this study, E5 did not reduce mortality in nonshock patients with Gram-negative sepsis whether or not those patients also had organ failure. However, E5 did result in greater resolution of organ failure in patients with Gram-negative sepsis. This benefit extended to those patients with suspected Gram-negative etiology. This finding is important because patients with suspected Gram-negative sepsis and organ failure can be identified without waiting for culture results. In addition, E5 resulted in the prevention of adult respiratory distress syndrome and central nervous system organ failure. However, more studies are needed to determine if this result can be extended to organ failure in general. E5 is safe as a treatment for patients with Gram-negative sepsis.