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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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Oral rofecoxib (Vioxx) may have a role in controlling postoperative pain patients undergoing knee surgery.
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Ventilator-associated pneumonia (VAP) remains a difficult problem in critically ill patients, both in diagnosis and treatment.
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In this randomized, multicenter trial, early use of a pulmonary artery catheter in patients with shock, ARDS, or both did not significantly alter mortality or morbidity.
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Among patients aged 65 or older, 31% were delirious on admission to the ICU, and 70% experienced delirium at some time during their hospitalization.
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Meta-analysis of published clinical trials showed that a regimen of oral acetylcysteine administration along with hydration reduced the relative risk of developing contrast nephropathy by 56% among patients with pre-existing renal insufficiency.
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