Abstract:
BACKGROUND:Ventilator associated pneumonia (VAP) is one of the most serious nosocomial infections in Intensive Care Unit (ICU). The aim of this study was to evaluate a new approach to spare the carbapenems for the management of patients diagnosed with VAP due to Acinetobacter baumannii (A. baumannii). METHOD:This retrospective study was conducted on VAP patients presenting for treatment at tertiary care centre between May 2014 and March 2016. The case sheets of patients who have been treated for VAP with meropenem, antibiotic adjuvant entity (AAE) and colistin were analysed. RESULTS:Out of 113 patients analysed, 24 (21.3%) patients were having VAP due to MDR A. baumannii. Microbial sensitivity has shown that 87.5% of patients were sensitive to AAE and colistin whereas all of them were resistant to meropenem, imipenem and gentamycin. The mean treatment durations were 12.4±2.1, 13.2±2.4 and 14.3±2.1days for AAE, meropenem+colistin and AAE+colistin treatment groups. In AAE susceptible patients, the mean treatment duration and cost could be reduced by 23-24% and 43-53% if AAE is used empirically. In AAE-resistant patients, the mean treatment duration and cost could be reduced by 21% and 26% if AAE+colistin regime is used empirically instead of meropenem followed by AAE+colistin. CONCLUSIONS:Clinical assessment with microbial eradication and pharmaco-economic evaluation clearly shows benefits in using AAE empirically in the management of A. baumannii infected VAP cases.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Sathe P,Maddani S,Kulkarni S,Munshi Ndoi
10.1016/j.jcrc.2017.04.002subject
Has Abstractpub_date
2017-10-01 00:00:00pages
145-149eissn
0883-9441issn
1557-8615pii
S0883-9441(16)30915-7journal_volume
41pub_type
杂志文章abstract:OBJECTIVE:Intensive Care Units (ICU) acquired Pneumonia (ICU-AP) is one of the most frequent nosocomial infections in critically ill patients. Our aim was to determine the effects of having an ICU-AP in immunosuppressed patients with acute hypoxemic respiratory failure. DESIGN:Post-hoc analysis of a multinational, pro...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.09.027
更新日期:2020-09-29 00:00:00
abstract::The concept of permissive hypotension is a controversial topic in trauma care. While driving blood pressure to "normal" levels with large volume crystalloid infusions is not appropriate, definitive data on the target blood pressure for hypotensive resuscitation are lacking. Indeed, the concept of systolic blood pressu...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.11.017
更新日期:2014-04-01 00:00:00
abstract:PURPOSE:The purpose of the study is to describe the role of human metapneumovirus (hMPV) infection in critical illness and acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS:We collected clinical and demographic information from a retrospective chart review, comparing patients with and without an intens...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.09.035
更新日期:2016-02-01 00:00:00
abstract:BACKGROUNDS:Using biomarkers to predict mortality in patient with severe sepsis or septic shock is of importance, as these patients frequently have high mortality and unsatisfied outcome. N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) play extremely important roles in prognostic valu...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.12.008
更新日期:2015-06-01 00:00:00
abstract:PURPOSE:To investigate predictive powers of S100B and cell-free DNA (cfDNA) levels in patients in the intensive care unit (ICU) who have with intracranial hemorrhage (ICH) for prognosis. METHODS:Ninety-nine patients diagnosed with ICH were included in the study. The blood samples were drawn on the day of admittance to...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.03.005
更新日期:2013-10-01 00:00:00
abstract::Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical ...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2012.05.001
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:Sepsis is a lethal outcome of the inflammation and coagulation process. Human interleukin (IL)-6 and tumor necrosis factor (TNF) α are well-known inflammation factors closely associated with sepsis. In the present study, we aim to investigate the association of promoter-region polymorphisms IL-6 (-174G/C) rs180...
journal_title:Journal of critical care
pub_type: 杂志文章
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更新日期:2015-10-01 00:00:00
abstract:PURPOSE:Hyperosmolar therapies aim at controlling increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the effect of 7.5% hypertonic saline (HTS) on ICP and cerebral perfusion pressure (CPP) in children with severe TBI. MATERIALS AND METHODS:Medical...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.10.014
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:Hypoxia is one of the leading causes of anesthesia-related injury. In response to the limitations of conventional preoxygenation, Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) has been used as a method of providing both preoxygenation and apneic oxygenation during intubation. MATERIALS...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.06.011
更新日期:2016-12-01 00:00:00
abstract::Sepsis and SIRS is the outward manifestation of a generalized uncontrolled inflammatory response, which, if sustained, induces widespread endothelial damage and MODS. Immunomodulating therapies, at present, have proven ineffective in reducing morbidity and mortality, presumably because of the heterogeneous nature of s...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/s0883-9441(96)90024-6
更新日期:1996-06-01 00:00:00
abstract:PURPOSE:Severe sepsis is a time-dependent disease, and implementation of early treatment has been associated with mortality rate reduction. However, the literature is controversial regarding cost-effectiveness analysis of this intervention. The aim was to assess the cost-effectiveness of a managed protocol for the trea...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.03.008
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to investigate the pharmacokinetics of combined intravenous (i.v.) and intracerebroventricular (i.c.v.) vancomycin for patients with intracranial infections after craniotomy and to provide the basis for establishing the intracranial local administration criterion. METHODS:Fourtee...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.020
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:To determine if recruitment manoeuvres (RMs) would decrease 28-day mortality of patients with acute respiratory distress syndrome (ARDS) compared with standard care. MATERIALS AND METHODS:Relevant randomized controlled trials (RCTs) published prior to April 26, 2018 were systematically searched. The primary ou...
journal_title:Journal of critical care
pub_type: 杂志文章,meta分析
doi:10.1016/j.jcrc.2018.10.033
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To develop and internally validate a prediction rule for the presence of candidemia in patients with severe sepsis and septic shock (candidemia rule) that will fill the gap left by previous rules. To compare the accuracy of the available Candida prediction models. DESIGN:Retrospective cohort study. SETTING:...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.03.010
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:To discharge a patient from the intensive care unit (ICU) is a complex decision-making process because in-hospital mortality after critical illness may be as high as up to 27%. Static C-reactive protein (CRP) values have been previously evaluated as a predictor of post-ICU mortality with conflicting results. Th...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2011.10.013
更新日期:2012-10-01 00:00:00
abstract:PURPOSE:To investigate magnesium as prophylaxis or treatment of postoperative arrhythmias in cardiac surgery (CS) patients. To assess impact on biochemical and patient-centered outcomes. MATERIALS AND METHODS:We searched MEDLINE, CENTRAL and EMBASE electronic databases from 1975 to October 2015 using terms related to ...
journal_title:Journal of critical care
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jcrc.2017.05.038
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Continuous renal replacement therapy (CRRT) is an important tool in the care of critically ill patients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.11.012
更新日期:2014-04-01 00:00:00
abstract:PURPOSE:We present a new electromyographic index, named Engagement of Respiratory Muscle (ERM), for assessing the level of participation of respiratory muscles during spontaneous breathing test in patients poisoned with organophosphorus compound. METHODS:Diaphragm and sternocleidomastoid muscles activity was recorded ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.05.022
更新日期:2017-10-01 00:00:00
abstract:PURPOSE:The aim of the study was to investigate possible associations between different heart rate variability (HRV) indices and various biomarkers of inflammation in 45 septic patients. MATERIALS AND METHODS:We daily assessed HRV in the time domain (SD of RR intervals [SDNN]), frequency domain (low [LF], high frequen...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.11.010
更新日期:2009-12-01 00:00:00
abstract:PURPOSE:The aim of this study was to investigate the role of inflammatory biomarkers and total bile acid (TBA) in oral secretions in the development of ventilator-associated pneumonia (VAP). MATERIALS:This prospective study was conducted in an intensive care unit. Oral secretions were collected from mechanically venti...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2011.12.008
更新日期:2012-10-01 00:00:00
abstract:PURPOSE:The purpose of this article is to elucidate the effect of L-canavanine, a selective inhibitor of inducible NO synthase (iNOS), on hemodynamics, blood gas parameters, and plasma concentrations of lactate and endothelin-1 (ET-1) during endotoxic shock. MATERIALS AND METHODS:Eleven mongrel dogs under pentobarbita...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2001.21792
更新日期:2001-03-01 00:00:00
abstract:PURPOSE:To validate a brief index of patient and family experiences of respect in the intensive care unit. MATERIAL AND METHODS:A survey including the 10-item ICU-RESPECT scale was administered to patients and family members in one ICU at a large west coast academic medical center. Confirmatory psychometric analyses w...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.03.026
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:With increasing emphasis on high-quality care, we designed this study to evaluate the relationship between Magnet® recognition and patient outcomes in pediatric critical care. MATERIALS AND METHODS:Post hoc analysis of data from an existing administrative national database. We used inverse probability of treat...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.09.004
更新日期:2018-02-01 00:00:00
abstract:PURPOSE:Acute kidney injury (AKI) is a common source of morbidity after trauma. We sought to determine novel risk factors for AKI, by Acute Kidney Injury Network (AKIN) criteria, in critically ill trauma patients. MATERIALS AND METHODS:A prospective cohort of 400 patients admitted to the intensive care unit of a level...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.02.002
更新日期:2012-10-01 00:00:00
abstract:PURPOSE:Increasingly, hospitals are engaging in continuous quality improvement (CQI) endeavors, aimed at optimizing patient care. Physician involvement is critical to the success of such initiatives. Little is known about any mediating factors that affect physician participation in these projects, though such knowledge...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2001.30165
更新日期:2001-12-01 00:00:00
abstract:PURPOSE:The aim of the study was to investigate predictors of post-intensive care unit (ICU) in-hospital mortality with special emphasis on the impact of sepsis and organ system failure. METHODS:This study is a subanalysis of the database from the observational Sepsis Occurrence in Acutely Ill Patients study conducted...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2007.09.006
更新日期:2008-12-01 00:00:00
abstract:PURPOSE:To examine relationships between self-report and performance-based measures of physical function in ICU patients randomized to standardized rehabilitation therapy (SRT) or usual care (UC). METHODS:Physical function was assessed in 257 ICU patients using self-report (physical functioning scale of the SF-36 (SF-...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.020
更新日期:2019-06-01 00:00:00
abstract:PURPOSE:Hyponatremia is frequently observed in intensive care unit (ICU) patients, but there is still lack information on the physiological mechanisms of development. MATERIALS AND METHODS:In this retrospective analysis we performed tonicity balances in 54 patients with ICU acquired hyponatremia. We calculated fluid a...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.05.017
更新日期:2013-12-01 00:00:00
abstract:PURPOSE:Little is known about the relationship between anxiety and pain in intensive care unit (ICU) patients despite its importance. The aims of the present study are to examine the correlation between pain and anxiety during ICU care and to investigate its effects on the dose of opioids and anxiolytics administered. ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.025
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The objective of this study is to explore the attitudes, knowledge, and behavior of house staff physicians regarding the use of ultrasound guidance (UG) during central venous catheter placement (CP). MATERIALS AND METHODS:A questionnaire-based study was used to survey house staff in multiple training programs ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.06.005
更新日期:2005-09-01 00:00:00