Robert A. Balk

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An American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference was held in Northbrook in August 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae. New definitions were offered for some terms, while others were discarded. Broad definitions of sepsis and the(More)
OBJECTIVE To determine whether plasma tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and lipopolysaccharide are detectable in patients when they first present with the sepsis syndrome and to determine whether levels correlate with patient survival. DESIGN Prospective study comparing patients with the sepsis(More)
OBJECTIVE To further define the safety and efficacy of recombinant human interleukin 1 receptor antagonist (rhIL-1ra) in the treatment of sepsis syndrome. STUDY DESIGN Randomized, double-blind, placebo-controlled, multicenter, multinational clinical trial. POPULATION A total of 893 patients with sepsis syndrome received an intravenous loading dose of(More)
BACKGROUND A recombinant, soluble fusion protein that is a dimer of an extracellular portion of the human tumor necrosis factor (TNF) receptor and the Fc portion of IgG1 (TNFR:Fc) binds and neutralizes TNF-alpha and prevents death in animal models of bacteremia and endotoxemia. METHODS To evaluate the safety and efficacy of TNFR:Fc in the treatment of(More)
OBJECTIVE To evaluate the efficacy and safety of anti-tumor necrosis factor alpha monoclonal antibody (TNF-alpha MAb) in the treatment of patients with sepsis syndrome. DESIGN Randomized, prospective, multicenter, double-blind, placebo-controlled clinical trial. SETTING A total of 31 hospitals in the United States and Canada. PATIENTS There were 994(More)
OBJECTIVE To evaluate the safety and potential efficacy of aerosolized surfactant in intubated patients with adult respiratory distress syndrome (ARDS). DESIGN A prospective, double-blind, placebo-controlled, randomized, parallel, multicenter pilot clinical trial. PATIENTS A total of 51 patients with sepsis-induced ARDS were entered into the study(More)
BACKGROUND Community-acquired pneumonia is a leading infectious cause of hospitalization and death among U.S. adults. Incidence estimates of pneumonia confirmed radiographically and with the use of current laboratory diagnostic tests are needed. METHODS We conducted active population-based surveillance for community-acquired pneumonia requiring(More)
BACKGROUND In patients with the acute respiratory distress syndrome, pneumothorax and other air leaks - any extrusion of air outside the tracheobronchial tree - have been attributed to high ventilatory pressures or volumes and linked to increased mortality. METHODS We analyzed data from a prospective trial of aerosolized synthetic surfactant in 725(More)
Sepsis is a systemic inflammatory response to the presence of infection, mediated via the production of many cytokines, including tumour necrosis factor (TNF-), interleukin (IL)-6, and IL-1, which cause changes in the circulation and in the coagulation cascade. There is stagnation of blood flow and poor oxygenation, subclinical coagulopathy with elevated(More)