Leonardo Lorente

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RATIONALE Subglottic secretion drainage (SSD) appears to be effective in preventing ventilator-associated pneumonia (VAP), primarily by reducing early-onset pneumonia; but it may not prevent late-onset pneumonia. We tested the hypothesis using an endotracheal tube incorporating an ultrathin polyurethane cuff (which reduces channel formation and fluid(More)
The standard mode of administration of piperacillin treatment is by intermittent infusion. However, continuous infusion may be advantageous as beta-lactam antibiotics exhibit time-dependent antibacterial activity. In previous studies, we found a higher rate of clinical cure of ventilator-associated pneumonia (VAP) by continuous infusion rather than(More)
BACKGROUND It is known that beta-lactam antibiotics exhibit time-dependent bactericidal activity. Several studies have found continuous infusion of meropenem more effective than intermittent infusion in maintaining constant serum concentrations in excess of the minimum inhibitory concentration. However, limited data exist on the clinical efficacy of(More)
INTRODUCTION Central venous catheterization is commonly used in critically ill patients and may cause different complications, including infection. Although there are many studies about CVC-related infection, very few have analyzed it in detail. The objective of this study was to analyze the incidence of catheter-related local infection (CRLI) and(More)
BACKGROUND Beta-lactam antibiotics are reported to exhibit time-dependent bactericidal activity. However, there are limited data on the clinical efficacy of ceftazidime administered by continuous infusion. OBJECTIVE The objective of this study was to compare the clinical efficacy of ceftazidime administered by continuous infusion and by intermittent(More)
BACKGROUND Estimating attributable mortality of ventilator-associated pneumonia has been hampered by confounding factors, small sample sizes, and the difficulty of doing relevant subgroup analyses. We estimated the attributable mortality using the individual original patient data of published randomised trials of ventilator-associated pneumonia prevention.(More)
INTRODUCTION Matrix metalloproteinases (MMPs) play a role in infectious diseases through extracellular matrix (ECM) degradation, which favors the migration of immune cells from the bloodstream to sites of inflammation. Although higher levels of MMP-9 and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) have been found in small series of patients(More)
OBJECTIVE The aim of this study was to analyze the prevalence of ventilator-associated pneumonia (VAP) using a closed-tracheal suction system vs. an open system. DESIGN Prospective and randomized study, from October 1, 2002, to December 31, 2003. SETTING A 24-bed medical-surgical intensive care unit in a 650-bed tertiary hospital. PATIENTS Patients(More)
INTRODUCTION Which particular arterial catheter site is associated with a higher risk of infection remains controversial. The Centers for Disease Control and Prevention guidelines of 1996 and the latest guidelines of 2002 make no recommendation about which site or sites minimize the risk of catheter-related infection. The objective of the present study was(More)