Tag: pneumonia
Overuse of troponin? A comprehensive evaluation of testing in a large hospital system
Troponin assays are integral to the diagnosis of acute myocardial infarction (AMI), but there is concern that testing is over utilized and may not conform to published guidelines. We reviewed all testing performed at 14 hospitals... read more
Corticosteroid Treatment in Critically Ill Patients with Severe Influenza Pneumonia
Administration of corticosteroids in patients with severe influenza pneumonia is associated with increased ICU mortality, and these agents should not be used as co‑adjuvant therapy. A total of 1846 patients with primary... read more
Peripheral Vasopressors: The Myth and the Evidence
You are working in a small, rural hospital staffed by one physician and one nurse. There are multiple sick patients, all of whom require your attention, but the sickest is probably the 62 year old female with pneumonia and... read more
Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD
Influenza vaccination significantly reduced influenza-related hospitalization among patients with Chronic Obstructive Pulmonary Disease (COPD). Initiatives to increase vaccination uptake and early use of antiviral agents... read more
Clinical Performance of Beta-D-Glucan for the Diagnosis of Pneumocystis Pneumonia in Cancer Patients Tested with PCP PCR
Patients negative by both Beta-D glucan (BDG) and PCR were unlikely to have Pneumocystis pneumonia (PCP). In patients with a compatible clinical syndrome for PCP, higher BDG values (>200 pg/mL) were consistently associated... read more
Decontaminants Don’t Cut Bloodstream Infection Risk in Ventilated ICU Patients
The use of digestive and oral decontaminants in patients in the intensive care unit (ICU) who are mechanically ventilated and who have moderate to high antibiotic resistance is not associated with a reduction in ICU-acquired... read more
Proton-Pump Inhibitor Prophylaxis in the ICU
Critical illness can disrupt local and systemic mechanisms that protect against upper gastrointestinal bleeding, a condition that may be associated with increased mortality, particularly among patients receiving extracorporeal... read more
Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe TBI
Among patients with severe traumatic brain injury (TBI), early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic... read more
Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia
This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the noninferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in... read more
ICU Usage for Pneumonia Doubles Length of Hospital Stay
A recently released report using data from the National Hospital Care Survey (NHCS) verifies existing data on the prevalence of pneumonia in hospitalizations and emergency department (ED) visits and provides the first-ever... read more
ECMO for Severe ARDS
Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every... read more
Validation and Clinical Implications of the IDSA/ATS Minor Criteria for Severe Community-Acquired Pneumonia
These findings support the use of the IDSA/ATS minor criteria to predict hospital mortality and guide ICU admission in inpatients with Community-Acquired Pneumonia (CAP) who do not require emergency mechanical ventilation... read more
Initial Inflammatory Profile in Community-acquired Pneumonia Depends on Time since Onset of Symptoms
Time since symptom onset modifies the systemic inflammatory profile at Community-acquired Pneumonia (CAP) diagnosis. This information has relevant clinical implications for management, and it should be taken into account... read more
The Effect of Alcohol Consumption on the Risk of ARDS
Chronic high alcohol consumption significantly increases the risk of ARDS. This finding suggests that patients admitted to hospital should be screened for chronic alcohol use. Seventeen observational studies (177,674 people)... read more
Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features
Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features: A multicenter study in southern Brazil. The main objective is to evaluate the incidence and risk factors of pressure ulcers (PU) in adult... read more
Distinguishing Pneumonia From Pneumonitis to Safely Discontinue Antibiotics
Consequences of pulmonary aspiration can be biphasic with dissimilar sequelae. An early phase, coined pneumonitis, involves an inflammatory reaction to gastrointestinal contents with a pH typically less than 2.4 resulting... read more
Immunocompromised Patients with ARDS
Immunosuppression is frequent in patients with acute respiratory distress syndrome (ARDS), and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent... read more
Automated System Detects Risk of VAP
Approximately 50 percent of all patients receiving mechanical ventilator support develop ventilator-associated pneumonia (VAP). Researchers at Massachusetts General Hospital (MGH) have developed an automated system for identifying... read more
A 10-year review of total hospital onset ICU bloodstream infections at an Academic Medical Center
Across all ICUs, the rates of primary BSIs progressively fell from 2.11/1000 patient days in FY05 to 0.32/1000 patient days in FY14; an 85.0% decrease (P<0.0001). Secondary BSIs also progressively decreased from 3.56/1000... read more
Metabolic Profiles in Community-Acquired Pneumonia
This study demonstrates that serum metabolomics approaches based on the LC-MS/MS platform can be applied as a tool to reveal metabolic changes during CAP and establish a metabolite signature related to disease severity. The... read more
Mechanical Ventilation: Physiological and Clinical Applications
Known for its simple explanations and in-depth coverage of patient-ventilator management, this evidence-based text walks readers through the most fundamental and advanced concepts surrounding mechanical ventilation and guides... read more
Empiric Antibiotics Tend To Be Prolonged in ICU
Using antibiotics in critically ill patients is very much walking a tightrope. No one wants to miss an infection in a patient who could go downhill quickly, but no one wants to overuse these precious drugs, either.... read more
