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BACKGROUND Catheter-related bloodstream infections occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. METHODS We conducted a collaborative cohort study predominantly in ICUs in Michigan. An evidence-based intervention was used to reduce the incidence of catheter-related bloodstream infections. Multilevel Poisson(More)
OBJECTIVE To assess the outcome of adult hematopoietic stem cell transplantation (HSCT) recipients who were admitted to a medical ICU (MICU), and to identify the measurable predictors of their MICU outcome. DESIGN Retrospective chart review study. SETTING MICU in a tertiary care, university-affiliated medical center with a comprehensive cancer program.(More)
PURPOSE The aim of this study was to describe the design and lessons learned from implementing a large-scale patient safety collaborative and the impact of an intervention on teamwork climate in intensive care units (ICUs) across the state of Michigan. MATERIALS AND METHODS This study used a collaborative model for improvement involving researchers from(More)
OBJECTIVES (a) To determine whether placing patients with acute respiratory distress syndrome in the prone position by a light-weight portable support frame improves oxygenation, (b) whether one can determine which patients benefit from prone positioning, and (c) to determine an effective technique for prone positioning of patients. DESIGN Prospective,(More)
INTRODUCTION Blood pressure measurements frequently guide management in critical care. Direct readings, commonly from a major artery, are considered to be the gold standard. Because arterial cannulation is associated with risks, alternative noninvasive blood pressure (NIBP) measurements are routinely used. However, the accuracy of NIBP determinations in(More)
Invasive hemodynamic procedures are increasingly used for monitoring critically ill and injured patients. The results of a prospective study on complications of 210 vascular catheterizations in 116 critically ill patients are reported. A total of 80 central venous (CV), 71 pulmonary artery (PA), and 59 arterial (A) catheterizations were performed during an(More)
The immunoconjugate XMMCO-791/RTA consists of ricin A chain bound to a murine monoclonal antibody MoAb 791T. This monoclonal antibody (MoAb) binds to a glycoprotein of 72 kD, which is expressed on human colorectal carcinoma, ovarian carcinoma, and osteogenic sarcoma. XMMCO-791/RTA was tested in a Phase I trial with proposed dose escalation steps of 0.02,(More)
We compared agreement between creatinine clearance values in obese, critically ill patients calculated using three common empirically derived formulas and modifications thereof, with creatinine clearance obtained by conventional 24-hour urine collection. We selected the charts of 22 patients in intensive care units (86% medical, 14% surgical) according to(More)
Presented is a case of a 22-year-old male bone marrow transplant recipient who developed severe methotrexate-induced oropharyngeal mucositis and respiratory insufficiency caused by sepsis. Coagulopathy and severe thrombocytopenia precluded surgical tracheostomy; however, dilatational percutaneous tracheostomy was performed uneventfully. The tracheostomy(More)
We describe the case of a 29 year-old female who presented with right sided hemiparesis with global aphasia. She had a history of transient ischemic attack with migraine headaches. Diagnostic workup revealed a right to left cardiac shunt. An isolated right pulmonary artery to left pulmonary vein fistula was diagnosed on pulmonary angiogram. The fistula was(More)