Alejandro C Arroliga

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CONTEXT The outcome of patients receiving mechanical ventilation for particular indications has been studied, but the outcome in a large number of unselected, heterogeneous patients has not been reported. OBJECTIVE To determine the survival of patients receiving mechanical ventilation and the relative importance of factors influencing survival. DESIGN,(More)
BACKGROUND Previous trials suggesting that high-frequency oscillatory ventilation (HFOV) reduced mortality among adults with the acute respiratory distress syndrome (ARDS) were limited by the use of outdated comparator ventilation strategies and small sample sizes. METHODS In a multicenter, randomized, controlled trial conducted at 39 intensive care units(More)
Pulmonary arterial hypertension (PAH), a fatal disease of unknown etiology characterized by impaired regulation of pulmonary hemodynamics and vascular growth, is associated with low levels of pulmonary nitric oxide (NO). Based upon its critical role in mediating vasodilation and cell growth, decrease of NO has been implicated in the pathogenesis of PAH. We(More)
Idiopathic pulmonary arterial hypertension (IPAH) is pathogenetically related to low levels of the vasodilator nitric oxide (NO). Because NO regulates cellular respiration and mitochondrial biogenesis, we hypothesized that abnormalities of bioenergetics may be present in IPAH. Evaluation of pulmonary artery endothelial cells from IPAH and control lungs in(More)
OBJECTIVE To determine the degree of concordance between clinical cause of death and autopsy diagnosis in a medical ICU (MICU) setting. DESIGN Retrospective medical chart and autopsy report review. SETTING MICU in a tertiary referral hospital. PATIENTS Consecutive admissions to an MICU over a 2-year period from January 1, 1994, to December 31, 1995.(More)
CONTEXT Ventilator-associated pneumonia (VAP) causes substantial morbidity. A silver-coated endotracheal tube has been designed to reduce VAP incidence by preventing bacterial colonization and biofilm formation. OBJECTIVE To determine whether a silver-coated endotracheal tube would reduce the incidence of microbiologically confirmed VAP. DESIGN,(More)
CONTEXT The long-term survival of patients with cirrhosis of the liver admitted to the ICU has not been described. OBJECTIVE The main objectives were to determine the 1-year and 5-year mortality rates of a cohort of patients admitted to a medical ICU (MICU), and to identify the risk factors that may predict long-term outcomes. DESIGN This is a cohort(More)
STUDY OBJECTIVE To study the diagnostic role of flexible bronchoscopy (FB) in immunocompromised patients with pulmonary infiltrates. DESIGN Prospective, observational study. SETTING Tertiary care hospital. PATIENTS A total of 104 consecutive non-HIV-infected immunocompromised patients with lung infiltrates in whom FB was performed. METHODS The(More)
BACKGROUND AND OBJECTIVE Cirrhotic patients admitted to the medical ICU (MICU) are associated with high mortality rates and high resource utilization. This study identifies specific predictors of increased mortality and resource utilization and uses them to develop and validate prognostic models in cirrhotic patients admitted to the MICU. METHODS(More)
Primary pulmonary hypertension (PPH) is a rare and fatal disease of unknown etiology. Inflammatory oxidant mechanisms and deficiency in nitric oxide (NO) have been implicated in the pathogenesis of pulmonary hypertension. In order to investigate abnormalities in oxidants and antioxidants in PPH, we studied intrapulmonary NO levels, biochemical reaction(More)