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This meta-analysis of clinical trials of steroids in septic shock demonstrates that whereas short-term, high-dose administration actually worsens survival, giving lower doses for a longer period hastens shock resolution and improves survival.
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Ventilator-associated pneumonia (vap) is nosocomial pneumonia occurring in a mechanically ventilated patient > 48 hours after intubation. It is categorized as early-onset (defined by most experts as 48-96 hours after intubation) and late-onset (> 2-96 hours after intubation): these differ with respect to responsible bacterial agents as well as outcomes. With an estimated incidence of 8-28% of intensive care unit (ICU) patients, or 13-35 cases per 1000 ventilator-days, VAP is common.
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Cognitive Effects of Estrogen Therapy; Vitamin Therapy and Restenosis; Echinacea and the Common Cold; Effects of Paxil in Children Under 18; FDA Actions.
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In a randomized, clinical trial involving patients with ALI/ARDS from non-sepsis etiologies, inhaled nitric oxide at 5 ppm failed to improve any of the clinically meaningful outcomes.
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A standardized withdrawal-of-life-support order form was viewed as helpful by physicians and nurses and changed medication delivery in a positive manner.
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Leapfrog Groups standards for critical care are not grounded sufficiently in evidence to mandate their stringent and universal implementation. Rather, most of the guidelines are grounded in common sense and rational extrapolation of the data. As such, they are a reasonable starting point for debate by physicians and policymakers about optimal methods of achieving intensivist-guided care of critically ill patients.
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No CT variables predicted severe in-hospital morbidity and mortality (death from pulmonary embolism, death from any cause, or cardiac arrest) in patients with PE. However, ventricular septal bowing and increased RV/LV diameter ratio were both strongly predictive of less severe morbidity, namely, subsequent ICU admission, and oligemia was associated with subsequent intubation and vasopressor use.
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Noninvasive positive-pressure ventilation (NPPV) was assessed in 105 patients with severe acute hypoxemic respiratory failure. The use of noninvasive positive pressure ventilation (NPPV) is effective to reduce intubation and mortality in patients with acute hypoxemic respiratory failure.
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