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ObjectiveFew outcome data are available about posterior reversible encephalopathy syndrome (PRES). We studied 90-day functional outcomes and their determinants in patients with severe PRES.Design70 patients with severe PRES admitted to 24 ICUs in 2001–2010 were included in a retrospective cohort study. The main outcome measure was a Glasgow Outcome Scale (GOS) of 5 (good recovery) on day 90.Main ResultsConsciousness impairment was the most common clinical sign, occurring in 66 (94%) patients. Clinical seizures occurred in 57 (81%) patients. Median mean arterial pressure was 122 (105–143) mmHg on scene. Cerebral imaging abnormalities were bilateral (93%) and predominated in the parietal (93%) and occipital (86%) white matter. Median number of brain areas involved was 4 (3–5). Imaging abnormalities resolved in 43 (88%) patients. Ischaemic and/or haemorrhagic complications occurred in 7 (14%) patients. The most common causes were drug toxicity (44%) and hypertensive encephalopathy (41%). On day 90, 11 (16%) patients had died, 26 (37%) had marked functional impairments (GOS, 2 to 4), and 33 (56%) had a good recovery (GOS, 5). Factors independently associated with GOS<5 were highest glycaemia on day 1 (OR, 1.22; 95%CI, 1.02–1.45, p = 0.03) and time to causative-factor control (OR, 3.3; 95%CI, 1.04–10.46, p = 0.04), whereas GOS = 5 was associated with toxaemia of pregnancy (preeclampsia/eclampsia) (OR, 0.06; 95%CI, 0.01–0.38, p = 0.003).ConclusionsBy day 90 after admission for severe PRES, 44% of survivors had severe functional impairments. Highest glycaemia on day 1 and time to causative-factor control were strong early predictors of outcomes, suggesting areas for improvement.

After participating in this activity, the participant should be better able to:1. Illustrate factors associated with arterial catheter-related colonization.2. Explain risk factors associated with central venous catheter-associated colonization.3. Use this information in a clinical setting.Unless otherwise noted below, each faculty or staff's spouse/life partner (if any) has nothing to disclose.Dr. Timsit has disclosed that he received grants/research fees from Jousea-Cilog, Pfizer, and MSD; was a consultant/advisor for 3M, Core Fusion, and Sanofi-Pasteur; and was on the speaker's bureau for Astelles. He is currently receiving grants/reserach fees from Ethicon; is a consultant/advisor for 3M and Core Fusion; and is on the speaker's bureau for Astelles. The remaining authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity.All faculty and staff in a position to control the content of this CME activity have disclosed that they have no financial relationship with, or financial interests in, any commercial companies pertaining to this educational activity.Visit the Critical Care Medicine Web site (www.ccmjournal.org) for information on obtaining continuing medical education credit. Background: Scheduled replacement of central venous catheters and, by extension, arterial catheters, is not recommended because the daily risk of catheter-related infection is considered constant over time after the first catheter days. Arterial catheters are considered at lower risk for catheter-related infection than central venous catheters in the absence of conclusive evidence. Objectives: To compare the daily risk and risk factors for colonization and catheter-related infection between arterial catheters and central venous catheters.Methods: We used data from a trial of seven intensive care units evaluating different dressing change intervals and a chlorhexidine-impregnated sponge. We determined the daily hazard rate and identified risk factors for colonization using a marginal Cox model for clustered data.Results: We included 3532 catheters and 27,541 catheter-days. Colonization rates did not differ between arterial catheters and central venous catheters (7.9% [11.4/1000 catheter-days] and 9.6% [11.1/1000 catheterdays], respectively). Arterial catheter and central venous catheter catheterrelated infection rates were 0.68% (1.0/1000 catheter-days) and 0.94% (1.09/ 1000 catheter-days), respectively. The daily hazard rate for colonization increased steadily over time for arterial catheters (p ‫؍‬ .008) but remained