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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
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Associations between the number of patients managed (hospital volume) and improved patient survival have been extensively documented in the surgical literaturesuch as cardiac surgery, ruptured aortic aneurysm, and several types of cancer surgeryand suggested for selected medical conditions, such as acute myocardial infarction and the acquired immunodeficiency syndrome.
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Over a 3-month period, all patients who required mechanical ventilation in the ICU of Tygerberg Academic Hospital in Cape Town, South Africa, were enrolled in this study.
