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Both intra-abdominal hypertension and evidence for its adverse physiologic effects were common in this retrospective series of ICU patients with severe acute pancreatitis, although there was no association with mortality, and 3 of 4 patients subjected to decompressive laparotomy died.
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In a randomized, controlled trial, patients with stroke or head injury who required mechanical ventilation were less likely to develop ventilator-associated pneumonia if they underwent early percutaneous gastrostomy for nutritional support than if they continued to be fed via nasogastric tube.
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Airway Management is an integral and frequent component of care of the critically ill.
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This prospective 10-year study of 7356 patients with ST-elevation MI who presented in cardiogenic shock showed once again that early mechanical revascularization (as recommended by current guidelines) substantially increases survival; it also suggests that adherence to the guidelines needs to be further improved.
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In 2001, the PROWESS trial of 1690 patients with severe sepsis1 demonstrated that a 96-hour infusion of activated protein C, or drotrecogin alfa (activated) (DrotAA, Xigris®) at 24 g/kg/h decreased mortality at 28 days from 30.8% to 24.4% (P = 0.005).
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Standard teaching advocates placing a chest tube on water seal in patients with a prior hemothorax or pneumothorax and obtaining a chest radiograph (CXR) the following morning.
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Uncontrolled hemorrhage remains an important cause of death in the ICU. Patients with severe traumatic injuries, gastrointestinal hemorrhage, and ruptured abdominal aortic aneurisms are but a few examples of those who develop coagulopathy and hemorrhage that is not amenable to surgical control and may not respond to traditional approaches to blood product transfusion.
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Studies using computed tomography have shown that patients with the acute respiratory distress syndrome (ARDS) typically have a cephalocaudal gradient in the distribution of lung density, with the greatest density (and collapse) in the lung bases adjacent to the diaphragm.
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It has been said that "medicine is a science, patient care is an art and healthcare is a business." To that end, physicians wear three hats, and must possess a broad range of skills to perform their jobs effectively. This demand is acutely evident in the tasks of an intensive care unit (ICU) director.
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New Hope for Macular Degeneration?; Can Cialis be Used for Edema?; FDA Actions
