2010 Oct 6 - Out-of-Hospital Hypertonic Resuscitation Following Severe Traumatic Brain Injury: A Randomized Controlled Trial
Context Hypertonic fluids restore cerebral perfusion with reduced cerebral edema and modulate inflammatory response to reduce subsequent neuronal injury and thus have potential benefit in resuscitation of patients with traumatic brain injury (TBI).
2010 Oct 6 - Chest Compression–Only CPR by Lay Rescuers and Survival From Out-of-Hospital Cardiac Arrest
Context Chest compression–only bystander cardiopulmonary resuscitation (CPR) may be as effective as conventional CPR with rescue breathing for out-of-hospital cardiac arrest.
Current debate in the medical community centers on the benefits of rapid response teams (RRTs), hospital-based teams composed of clinicians with intensive care unit (ICU)–level clinical expertise. These teams rapidly respond when the condition of patients being cared for outside of the ICU suddenly deteriorates, and such patients often require transfer to ICUs.1
2010 Sep 8 - Clinical Characteristics and 30-Day Outcomes for Influenza A 2009 (H1N1), 2008-2009 (H1N1), and 2007-2008 (H3N2) Infections
Context The clinical characteristics of pandemic 2009 influenza A(H1N1) infections have not been compared directly with illnesses caused by other influenza A strains.
2010 Aug 25 - Elective Intra-aortic Balloon Counterpulsation During High-Risk Percutaneous Coronary Intervention: A Randomized Controlled Trial
Figure. IABP tracing (Photo courtesy: ICU, PYNEH, Hong Kong)
Context Observational studies have previously reported that elective intra-aortic balloon pump (IABP) insertion may improve outcomes following high-risk percutaneous coronary intervention (PCI). To date, this assertion has not been tested in a randomized trial.
Hypothesis In patients with severe acute pancreatitis and abdominal compartment syndrome, establishment of the indications and optimal time for surgical decompression may avoid exacerbation of multiple-organ dysfunction syndrome.
2010 Aug 18 - System Delay and Mortality Among Patients With STEMI Treated With Primary Percutaneous Coronary Intervention
Context Timely reperfusion therapy is recommended for patients with ST-segment elevation myocardial infarction (STEMI), and door-to-balloon delay has been proposed as a performance measure in triaging patients for primary percutaneous coronary intervention (PCI). However, focusing on the time from first contact with the health care system to the initiation of reperfusion therapy (system delay) may be more relevant, because it constitutes the total time to reperfusion modifiable by the health care system. No previous studies have focused on the association between system delay and outcome in patients with STEMI treated with primary PCI.
Context Early identification of nontrauma patients in need of critical care services in the emergency setting may improve triage decisions and facilitate regionalization of critical care.
2010 Aug 9 - Simplification of the Pulmonary Embolism Severity Index for Prognostication in Patients With Acute Symptomatic Pulmonary Embolism
Background The Pulmonary Embolism Severity Index (PESI) estimates the risk of 30-day mortality in patients with acute pulmonary embolism (PE). We constructed a simplified version of the PESI.
Background Symptomatic intracerebral hemorrhage (sICH) is the most devastating complication of thrombolytic therapy for acute stroke. It is not clear whether patients with sICH continue to bleed after diagnosis, nor has the most appropriate treatment been determined.
Staphylococcus aureus, unlike many virulent pathogens, is a common commensal asymptomatically colonizing the nares1 and other body sites in approximately 30% of healthy individuals.
Context Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen of public health importance; MRSA prevention programs that may affect MRSA transmission and infection are increasingly common in health care settings. Whether there have been changes in MRSA infection incidence as these programs become established is unknown; however, recent data have shown that rates of MRSA bloodstream infections (BSIs) in intensive care units are decreasing.
2010 Jun 23 - Infection Rate and Acute Organ Dysfunction Risk as Explanations for Racial Differences in Severe Sepsis
Context Severe sepsis, defined as infection complicated by acute organ dysfunction, occurs more frequently and leads to more deaths in black than in white individuals. The optimal approach to minimize these disparities is unclear.
2010 Jun - Acute Hemorrhagic Leukoencephalitis and Hypoxic Brain Injury Associated With H1N1 Influenza
Objective To describe the first adult with neurologic complications associated with H1N1 influenza virus infection.
2010 Jun 16 - Association of Corticosteroid Dose and Route of Administration With Risk of Treatment Failure in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Context Systemic corticosteroids are beneficial for patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (COPD); however, their optimal dose and route of administration are uncertain.
Antibiotics are extraordinary medicine and are often curative. In general, antibiotics are remarkably free of adverse effects, eradicating the microorganism and usually leaving the host unaffected. Because antibiotics are typically well tolerated and effective, they are often used when the diagnosis of a bacterial infection is unclear. The liberal use of antibiotics has contributed to antibiotic resistance—a problem that has become a crisis.
2010 Jun 9 - Clinical Outbreak of Linezolid-Resistant Staphylococcus aureus in an Intensive Care Unit
Context Linezolid resistance is extremely uncommon in Staphylococcus aureus.
Context Long-term acute care hospitals have emerged as a novel approach for the care of patients recovering from severe acute illness, but the extent and increases in their activity at the national level are unknown.
Several investigations have rekindled important concern that administration of 100% oxygen during and early after resuscitation from experimental cardiopulmonary arrest might be deleterious to the brain.
2010 Jun 2 - Association Between Timeliness of Reperfusion Therapy and Clinical Outcomes in ST-Elevation Myocardial Infarction
Context Guidelines emphasize the importance of rapid reperfusion of patients with ST-elevation myocardial infarction (STEMI) and specify a maximum delay of 30 minutes for fibrinolysis and 90 minutes for primary percutaneous coronary intervention (PPCI). However, randomized trials and selective registries are limited in their ability to assess the effect of timeliness of reperfusion on outcomes in real-world STEMI patients.