Untitled

Crippen, David

doi:10.1186/cc3946

Crit Care

2006

DOI: 10.1186/cc3946

|View full text |Cite

Untitled

David Crippen

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2010

2011

Publication Types

Select...

Article3

Relationship

Self Cite1

Independent2

Authors

Journals

Cited by 3 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We learned the difficult lesson that trauma is not the major issue following a disaster [3]. The traditional influx of ad hoc rescue teams flooding into the area actually hinders progress, as it did after the 9/11 disaster in New York City [4].…”

mentioning

confidence: 99%

“…Even in an unforgiving environment, the principles of the Federal Emergency Management Agency (FEMA) still apply to the the command structure, albeit in a modified form [ 2 ]. We learned the difficult lesson that trauma is not the major issue following a disaster [ 3 ]. The traditional influx of ad hoc rescue teams flooding into the area actually hinders progress, as it did after the 9/11 disaster in New York City [ 4 ].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Disaster medicine: the caring contradiction

et al. 2010

Self Cite

View full text Add to dashboard Cite

The nature of mankind is a concern for those in need. Disasters, both natural and manmade, have been with us since the beginning of recorded history but media coverage of them is a relatively new phenomenon. When these factors come together, there is great potential to both identify and serve the sick and injured. However, the mass media by its nature tends to enhance the humanistic aspect of rescue while minimizing the practical problems involved. We describe a recent scenario in Haiti that puts some of these complications into a practical perspective.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Disaster medicine: the caring contradiction

et al. 2010

Self Cite

View full text Add to dashboard Cite

show abstract

Therapeutic Drug Monitoring of Piperacillin-Tazobactam Using Spent Dialysate Effluent in Patients Receiving Continuous Venovenous Hemodialysis

Connor

Salem

Bauer

et al. 2011

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Sepsis and multisystem organ failure are common diagnoses affecting nearly three-quarters of a million Americans annually. Infection is the leading cause of death in acute kidney injury, and the majority of critically ill patients who receive continuous dialysis also receive antibiotics. Dialysis equipment and prescriptions have gradually changed over time, raising concern that current drug dosing recommendations in the literature may result in underdosing of antibiotics. Our research group directed its attention toward antibiotic dosing strategies in patients with acute renal failure (ARF), and we sought data confirming that patients receiving continuous dialysis and antibiotics actually were achieving therapeutic plasma drug levels during treatment. In the course of those investigations, we explored "fast-track" strategies to estimate plasma drug concentrations. As most antimicrobial antibiotics are small molecules and should pass freely through modern high-flux hemodialyzer filters, we hypothesized that continuous renal replacement therapy (CRRT) effluent could be used as the medium for drug concentration measurement by reverse-phase high-pressure liquid chromatography (HPLC). Here we present the first data demonstrating this approach for piperacillin-tazobactam. Paired blood and dialysate trough-peak-trough samples were drawn from 19 patients receiving piperacillin-tazobactam and continuous venovenous hemodialysis (CVVHD). Total, free, and dialysate drug concentrations were measured by HPLC. Dialysate drug levels predicted plasma free drug levels well (r 2 ‫؍‬ 0.91 and 0.92 for piperacillin and tazobactam, respectively) in all patients. These data suggest a strategy for therapeutic drug monitoring that minimizes blood loss from phlebotomy and simplifies analytic procedures.

show abstract

Systematic Review and Meta-Analysis of the Efficacy of Appropriate Empiric Antibiotic Therapy for Sepsis

Paul

Shani

Muchtar

et al. 2010

Antimicrob Agents Chemother

628

432

View full text Add to dashboard Cite

Quantifying the benefit of early antibiotic treatment is crucial for decision making and can be assessed only in observational studies. We performed a systematic review of prospective studies reporting the effect of appropriate empirical antibiotic treatment on all-cause mortality among adult inpatients with sepsis. Two reviewers independently extracted data. Risk of bias was assessed using the Newcastle-Ottawa score. We calculated unadjusted odds ratios (ORs) with 95% confidence intervals for each study and extracted adjusted ORs, with variance, methods, and covariates being used for adjustment. ORs were pooled using random-effects meta-analysis. We examined the effects of methodological and clinical confounders on results through subgroup analysis or mixed-effect meta-regression. Seventy studies were included, of which 48 provided an adjusted OR for inappropriate empirical antibiotic treatment. Inappropriate empirical antibiotic treatment was associated with significantly higher mortality in the unadjusted and adjusted comparisons, with considerable heterogeneity occurring in both analyses (I 2 > 70%). Study design, time of mortality assessment, the reporting methods of the multivariable models, and the covariates used for adjustment were significantly associated with effect size. Septic shock was the only clinical variable significantly affecting results (it was associated with higher ORs). Studies adjusting for background conditions and sepsis severity reported a pooled adjusted OR of 1.60 (95% confidence interval ‫؍‬ 1.37 to 1.86; 26 studies; number needed to treat to prevent one fatal outcome, 10 patients [95% confidence interval ‫؍‬ 8 to 15]; I 2 ‫؍‬ 46.3%) given 34% mortality with inappropriate empirical treatment. Appropriate empirical antibiotic treatment is associated with a significant reduction in all-cause mortality. However, the methods used in the observational studies significantly affect the effect size reported. Methods of observational studies assessing the effects of antibiotic treatment should be improved and standardized.Sepsis affects 1.1 to 2.4 per 1,000 people per year and 20 to 42% of these patients die in hospital, with these rates probably underestimating the contribution of hospital-acquired infections (3, 16, 61). Septicemia and pneumonia combined are the sixth most common causes of death in the United States (36). Antibiotic treatment for the first 24 to 48 h is largely empirical (i.e., provided without evidence on the causative pathogen or its susceptibilities), and it is common wisdom that appropriate empirical antibiotic treatment (i.e., matching the in vitro susceptibilities of the isolated pathogens) reduces mortality. Physicians thus strive to achieve appropriate empirical antibiotic treatment for inpatients with suspected infections, and many times this is at the cost of administering superfluous and unnecessary antibiotics. Such treatment is associated with resistance development (83, 97) and side effects with no benefit.Estimates of the potential benefit of appropriate em...

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Untitled

Cited by 3 publications

References 5 publications

Disaster medicine: the caring contradiction

Disaster medicine: the caring contradiction

Therapeutic Drug Monitoring of Piperacillin-Tazobactam Using Spent Dialysate Effluent in Patients Receiving Continuous Venovenous Hemodialysis

Systematic Review and Meta-Analysis of the Efficacy of Appropriate Empiric Antibiotic Therapy for Sepsis

Contact Info

Product

Resources

About