Therapy of ventilator-associated pneumonia. A patient-based approach based on the ten rules of "The Tarragona Strategy"Alberto Sandiumenge
Department of Critical Care, Joan XXIII University Hospital, University Rovira and Virgili, C Doctor Mallafré Guasch, 4, 43007, Tarragona, Spain
Intensive Care Med 29:876-83. 2003
..The choice of initial antibiotic should be based on the patient's previous antibiotic exposure and comorbidities, and local antibiotic susceptibility patterns, which should be updated regularly...
Influence of genetic variability at the surfactant proteins A and D in community-acquired pneumonia: a prospective, observational, genetic studyM Isabel Garcia-Laorden
Department of Immunology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria 35010, Spain
Crit Care 15:R57. 2011
..We also studied the effect of genetic variability on SP-D serum levels...
- Host adaptive immunity deficiency in severe pandemic influenza
Jesus F Bermejo-Martin
Infection and Immunity Unit, Hospital Clínico Universitario IECSCYL, Avda, Ramon y Cajal 3, 47005 Valladolid, Spain
Crit Care 14:R167. 2010
..Pandemic A/H1N1/2009 influenza causes severe lower respiratory complications in rare cases. The association between host immune responses and clinical outcome in severe cases is unknown...
- Th1 and Th17 hypercytokinemia as early host response signature in severe pandemic influenza
Jesus F Bermejo-Martin
National Centre of Influenza, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
Crit Care 13:R201. 2009
..We utilize here systemic cytokine and antibody levels in evaluating differences in early immune response in both mild and severe patients infected with nvH1N1...
- Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, CIBERes Enfermedades Respiratorias, IISPV, Mallafre Guasch 4, 43007 Tarragona, Spain
Crit Care 13:R148. 2009
..We describe the clinical and epidemiologic characteristics of the first 32 persons reported to be admitted to the intensive care unit (ICU) due to influenza A (H1N1)v infection in Spain...
Severity of pneumococcal pneumonia associated with genomic bacterial loadJordi Rello
Critical Care Department, Hospital Universitari Joan XXIII, 43007 Tarragona, Spain
Chest 136:832-40. 2009
..As viral load is useful in viral infections, we hypothesized that bacterial load may be associated with outcomes in patients with pneumococcal pneumonia...
- Demographics, guidelines, and clinical experience in severe community-acquired pneumonia
Jordi Rello
Critical Care Department, Joan XXIII University Hospital University Rovira i Virgili, Pere Virgili Health Institut, CIBER Enfermedades Respiratorias CIBERES, Tarragona 43007, Spain
Crit Care 12:S2. 2008
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- Why mortality is increased in health-care-associated pneumonia: lessons from pneumococcal bacteremic pneumonia
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, Carrer Mallafre Guasch, 4, Tarragona 43007, Spain
Chest 137:1138-44. 2010
..A cohort of patients with bacteremic Streptococcus pneumoniae pneumonia was reviewed to assess why mortality is higher in health-care-associated pneumonia (HCAP) than in community-acquired pneumonia (CAP)...
- Severe Community-Acquired Pneumonia and PIRO: A New Paradigm of Management
Jordi Rello
Joan XXIII University Hospital, Carrer Mallafre Guasch 4, 43007 Tarragona, Spain
Curr Infect Dis Rep 11:343-8. 2009
..The CAP-PIRO score is a new, simple tool stratifying patients in four categories and may be useful for early identification of patients who may benefit from adjunctive therapy...
- Activity of a silver-coated endotracheal tube in preclinical models of ventilator-associated pneumonia and a study after extubation
Jordi Rello
Joan XXIII University Hospital, CIBER Enfermedades Respiratorias CIBERES, University Rovira i Virgili, IISPV, Tarragona, Spain
Crit Care Med 38:1135-40. 2010
..To elucidate the mechanism of action of the silver-coated endotracheal tube in models of the early pathogenesis of ventilator-associated pneumonia...
- Clinical review: primary influenza viral pneumonia
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, CIBERes Enfermedades Respiratorias, IISPV, Tarragona, Spain
Crit Care 13:235. 2009
..Ensuring an appropriate oxygenation and ventilation strategy, as well as prompt initiation of antiviral therapy, is essential in management...
- A European care bundle for prevention of ventilator-associated pneumonia
Jordi Rello
Critical Care Department, Vall d Hebron University Hospital, Institut de Recerca Vall d Hebron UAB, CibeRes, Barcelona, Spain
Intensive Care Med 36:773-80. 2010
..One recent approach to facilitating guideline implementation involves the use of care bundles...
- A European care bundle for management of ventilator-associated pneumonia
Jordi Rello
Critical Care Department, Vall d Hebron University Hospital, Institut de Recerca Vall d Hebron Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias CIBERES, Barcelona, Spain
J Crit Care 26:3-10. 2011
..Although there is a wealth of guidance concerning the management of patients with ventilator-associated pneumonia (VAP), compliance with recommendations concerning optimal treatment practices is highly variable...
- Determinants of prescription and choice of empirical therapy for hospital-acquired and ventilator-associated pneumonia
J Rello
Critical Care Department, Vall d Hebron University Hospital, Vall d Hebron Institut de Recerca, Universitat Autonoma de Barcelona, Passeig de la Vall d Hebron, 119 129, 08035, Barcelona, Spain
Eur Respir J 37:1332-9. 2011
..Across Europe, carbapenems were the antibiotic most prescribed for HAP/VAP...
- De-escalation therapy in ventilator-associated pneumonia
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, Tarragona, Spain
Crit Care Med 32:2183-90. 2004
..The impact of quantitative tracheal aspirates or bronchoscopic techniques was comparable in terms of mortality...
- PIRO score for community-acquired pneumonia: a new prediction rule for assessment of severity in intensive care unit patients with community-acquired pneumonia
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili, Institut Pere Virgili, CIBER Enfermedades Respiratorias, Tarragona, Spain
Crit Care Med 37:456-62. 2009
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- Radiologic progression of pulmonary infiltrates predicts a worse prognosis in severe community-acquired pneumonia than bacteremia
Thiago Lisboa
Critical Care Department, Joan XXIII University Hospital, CIBER Enfermedades Respiratorias, Carrer Mallafre Guasch, Tarragona, Spain
Chest 135:165-72. 2009
..The objective of this study was to investigate the relative importance of these two factors in the outcome of patients with severe CAP (sCAP)...
- Risk factors for ventilator-associated pneumonia by Pseudomonas aeruginosa in presence of recent antibiotic exposure
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili, Institut Pere Virgili, Carrer Dr Mallafre Guasch 4, 43007 Tarragona, Spain
Anesthesiology 105:709-14. 2006
....
- First influenza season after the 2009 pandemic influenza: report of the first 300 ICU admissions in Spain
A Rodriguez
Hospital Joan XXIII, Critical Care Department, IISPV, URV, CIBER Enfermedades Respiratorias, Tarragona, Spain
Med Intensiva 35:208-16. 2011
..MATERIAL METHODS: Prospective, observational, multi-center study conducted in 148 Spanish intensive care units (ICU) during epidemiological weeks 50-52 of 2010 and weeks 1 - 4 of 2011...
- Severe pandemic (H1N1)v influenza A infection: report on the first deaths in Spain
Ignacio Martin-Loeches
Critical Care Department, Joan XXIII University Hospital, Spain
Respirology 16:78-85. 2011
..The impact of pandemic influenza A (H1N1)v infection is still unknown but it is associated with a high case-fatality rate...
- Elevation of creatine kinase is associated with worse outcomes in 2009 pH1N1 influenza A infection
Bárbara Borgatta
Critical Care Department, Vall d Hebron University Hospital, Universitat Autonoma de Barcelona UAB, 08035, Barcelona, Spain
Intensive Care Med 38:1152-61. 2012
..Current medical knowledge lacks specific information regarding creatine kinase (CK) elevation in influenza A pH1N1 (2009) infection...
- A randomized trial of dental brushing for preventing ventilator-associated pneumonia
Angel Pobo
Critical Care Department, Joan XXIII University Hospital, 43007 Tarragona, Spain
Chest 136:433-9. 2009
..Poor oral hygiene is associated with respiratory pathogen colonization and secondary lung infection. The impact of adding electric toothbrushing to oral care in order to reduce ventilator-associated pneumonia (VAP) incidence is unknown...
- [Infection associated with the use of assisted-ventilation devices]
Emili Diaz
Servicio Medicina Intensiva, Hospital Universitari Joan XXIII, Tarragona, Spain
Enferm Infecc Microbiol Clin 26:465-70. 2008
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- The ventilator-associated pneumonia PIRO score: a tool for predicting ICU mortality and health-care resources use in ventilator-associated pneumonia
Thiago Lisboa
Critical Care Department, Joan XXIII University Hospital, Tarragona, Spain
Chest 134:1208-16. 2008
..No score is available to assess severity and stratify mortality risk in ventilator-associated pneumonia (VAP). Our objective was to develop a severity assessment tool for VAP patients...
- Hospital-acquired pneumonia in the 21st century: a review of existing treatment options and their impact on patient care
Despoina Koulenti
Critical Care Department, Joan XXIII University Hospital Institut Pere Virgili, Mallafre Guasch, 4, 43007 Tarragona, Spain
Expert Opin Pharmacother 7:1555-69. 2006
..The optimal duration of treatment is a matter of debate, but courses longer than 1 week are rarely justified...
- Management of ventilator-associated pneumonia in a multidisciplinary intensive care unit: does trauma make a difference?
Kemal Agbaht
CIBER Enfermedades Respiratorias, University of Rovira and Virgili, Critical Care Department, Joan XXIII University Hospital, Institut Pere Virgili, Carrer Dr Mallafre Guasch 4, 43007 Tarragona, Spain
Intensive Care Med 33:1387-95. 2007
..Antibiotic exposure and timing of pneumonia onset influence ventilator-associated pneumonia (VAP) isolates. The first goal of this investigation was to evaluate whether trauma also influences prevalence of microorganisms...
- Clinical resolution in patients with suspicion of ventilator-associated pneumonia: a cohort study comparing patients with and without acute respiratory distress syndrome
Loreto Vidaur
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili, Tarragona, Spain
Crit Care Med 33:1248-53. 2005
..ARDS patients with VAP take twice as long to resolve fever, whereas hypoxemia should be ignored in defining resolution in this subset...
- Bacteremia is an independent risk factor for mortality in nosocomial pneumonia: a prospective and observational multicenter study
Monica Magret
Critical Care Department, Vall d Hebron University Hospital, CibeRes, VHIR, Universitat Autonoma de Barcelona, Vall d Hebron St, Barcelona 08035, Spain
Crit Care 15:R62. 2011
..The purpose of the study is to compare risk factors, pathogens and outcomes between bacteremic nosocomial pneumonia (B-NP) and nonbacteremic nosocomial pneumonia (NB-NP) episodes...
- Impact of diversity of antibiotic use on the development of antimicrobial resistance
Alberto Sandiumenge
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili Institut Pere Virgili, Tarragona 43007, Spain
J Antimicrob Chemother 57:1197-204. 2006
..To evaluate the impact of different antibiotic strategies on acquisition of resistant microorganisms...
- Prospective observational study of bacteremic pneumococcal pneumonia: Effect of discordant therapy on mortality
Manel Lujan
Pulmonary Department, , Sabadell, Barcelona, Spain
Crit Care Med 32:625-31. 2004
..Clinical outcome is worse in those patients receiving antimicrobial therapy that in vitro testing suggests would be ineffective...
- Incidence, etiology, and outcome of nosocomial pneumonia in ICU patients requiring percutaneous tracheotomy for mechanical ventilation
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili, Carrer Dr Mallafre Guasch 4, 43007 Tarragona, Spain
Chest 124:2239-43. 2003
..To determine the epidemiology of pneumonia in patients with tracheotomy receiving short-term mechanical ventilation...
- Bacteremia in patients with ventilator-associated pneumonia is associated with increased mortality: A study comparing bacteremic vs. nonbacteremic ventilator-associated pneumonia
Kemal Agbaht
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, Institut Pere Virgili, Tarragona, Spain
Crit Care Med 35:2064-70. 2007
..To assess whether bacteremic ventilator-associated pneumonia (B-VAP) differs in terms of risk factors, organisms, and outcomes from nonbacteremic VAP (NB-VAP)...
- Ventilator-associated pneumonia: impact of organisms on clinical resolution and medical resources utilization
Loreto Vidaur
Critical Care Department, Joan XXIII University Hospital and Pere Virgili Health Institute, Tarragona, Spain
Chest 133:625-32. 2008
..The aim of this study was to evaluate the influence of organisms and their susceptibility to treatment on outcomes...
- Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection
Ignacio Martin-Loeches
Critical Care Department, Joan XXIII University Hospital CIBER Enfermedades Respiratorias, URV, and IISPV, Mallafre i Guasch, ES 43007 Tarragona, Spain
Crit Care 15:R66. 2011
..Little information exists about the impact of acute kidney injury (AKI) in critically ill patients with the pandemic 2009 influenza A (H1N1) virus infection...
- A 7-year study of severe hospital-acquired pneumonia requiring ICU admission
Jordi Valles
Critical Care Center, Hospital Sabadell, Institut Universitari Parc Tauli Universitat Autónoma de Barcelona, Parc Tauli s n, 08208, Barcelona, Spain
Intensive Care Med 29:1981-8. 2003
..To examine the characteristics, prognostic factors, and outcome of patients with severe hospital-acquired pneumonia admitted to the ICU...
- Mortality in ICU patients with bacterial community-acquired pneumonia: when antibiotics are not enough
Alejandro Rodriguez
Critical Care Department, Pere Virgili Health Institut and CIBER Enfermedades Respiratorias, Joan XXIII University Hospital, Tarragona, Spain
Intensive Care Med 35:430-8. 2009
..It remains uncertain why immunocompetent patients with bacterial community-acquired pneumonia (CAP) die, in spite of adequate antibiotics...
- Reduced burden of bacterial airway colonization with a novel silver-coated endotracheal tube in a randomized multiple-center feasibility study
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, Tarragona, Spain
Crit Care Med 34:2766-72. 2006
..To assess the feasibility and safety of the respiratory infection control (RIC) device, a silver-coated endotracheal tube, and its effect on bacterial burden in the airways...
- Impact of nonexacerbated COPD on mortality in critically ill patients
Alejandro Rodriguez
Critical Care Department, Joan XXIII University Hospital, CIBERes Enfermedades Respiratorias, Universidad Rovira i Virgili IISPV, Tarragona, Spain
Chest 139:1354-60. 2011
..The real contribution of nonexacerbated COPD to mortality has not been studied. The aim of our study was to evaluate the impact of nonexacerbated COPD on mortality in patients requiring mechanical ventilation (MV)...
- Mortality and regional oxygen saturation index in septic shock patients: a pilot study
Alejandro Rodriguez
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias, Tarragona, Spain
J Trauma 70:1145-52. 2011
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- Nursing adherence with evidence-based guidelines for preventing ventilator-associated pneumonia
Maite Ricart
Critical Care Department, Joan XXIII University Hospital, Universitat Rovira i Virgili, Tarragona, Spain
Crit Care Med 31:2693-6. 2003
..Our findings suggest the need for development of multinational guidelines to reduce variability and the need to include the nursing point of view in these guidelines...
- Pneumonia caused by oxacillin-resistant Staphylococcus aureus treated with glycopeptides
Jordi Rello
Joan XXIII University Hospital, University Rovira and Virgili, Institut Pere Virgili, Tarragona, Spain
Crit Care Med 33:1983-7. 2005
..75 days) days for controls (p = .054). CONCLUSIONS: Despite appropriate glycopeptide therapy, there is an increased attributable mortality for pneumonia by ORSA, after careful adjustment for disease severity and diagnostic category...
- Microbiological testing and outcome of patients with severe community-acquired pneumonia
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, Tarragona, Spain
Chest 123:174-80. 2003
..The study documents the impact of microbiological investigations on therapeutic decisions and outcome in patients with severe community-acquired pneumonia (SCAP)...
- Ventilator-associated pneumonia in trauma patients is associated with lower mortality: results from EU-VAP study
M Magret
Critical Care Department, Sant Joan University Hospital, Reus, Spain
J Trauma 69:849-54. 2010
..Differences in trauma patients developing ventilator-associated pneumonia (VAP) are described regarding etiology and risk factors associated. We aim to describe the differences in outcomes in trauma and nontrauma patients with VAP...
- Impact of early oseltamivir treatment on outcome in critically ill patients with 2009 pandemic influenza A
Alejandro Rodriguez
Hospital Joan XXIII, Critical Care Department IISPV URV CIBERES, Tarragona, Spain
J Antimicrob Chemother 66:1140-9. 2011
..The main objective of this study was to investigate the relationship between the timing of antiviral administration and intensive care unit (ICU) outcomes...
- Epidemiology and outcomes of ventilator-associated pneumonia in a large US database
Jordi Rello
University Hospital Joan XXIII, University Rovira and Virgili, Tarragona, Spain
Chest 122:2115-21. 2002
..While strategies to prevent the occurrence of VAP may not reduce mortality, they may yield other important benefits to patients, their families, and hospital systems...
- Risk factors for pneumonia in the intubated patient
Olga Diaz
Critical Care Department, Hospital Doce de Octubre, Madrid, Spain
Infect Dis Clin North Am 17:697-705. 2003
..This variable should be considered when stratifying patients for risk factor analysis and also in the design of clinical trials for VAP prophylaxis...
- Impact of obesity in patients infected with 2009 influenza A(H1N1)
Emili Diaz
Critical Care Department, Hospital Universitario Joan XXIII CIBER Enfermedades Respiratorias, URV, and IISPV, Carrer Dr, Mallafre Guasch 4, 43007 Tarragona, Spain
Chest 139:382-6. 2011
..However, its role remains unclear. We evaluate the outcome of patients who are obese and infected with A(H1N1) in the ICU, determining whether obesity is a risk factor for mortality...
- Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza
Emili Diaz
Critical Care Department, Hospital Sant Joan Despí Moisès Broggi, Jacint Verdaguer, 90, 08970 Sant Joan Despí, Barcelona, CibeRes, IISPV, Spain
J Infect 64:311-8. 2012
..The objective of this study was to assess the effect on survival of corticosteroid therapy in patients with pandemic (H1N1) 2009 influenza...
- Combination antibiotic therapy improves survival in patients with community-acquired pneumonia and shock
Alejandro Rodriguez
Intensive Care Unit, Joan XXIII University Hospital, Tarragona, Spain
Crit Care Med 35:1493-8. 2007
..To assess whether combination antibiotic therapy improves outcome of severe community-acquired pneumonia in the subset of patients with shock...
- C-reactive protein correlates with bacterial load and appropriate antibiotic therapy in suspected ventilator-associated pneumonia
Thiago Lisboa
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili, Institut Pere Virgili, CIBER Enfermedades Respiratorias, Tarragona, Spain
Crit Care Med 36:166-71. 2008
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- Management of ventilator-associated pneumonia caused by multiresistant bacteria
Emili Diaz
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili Institut Pere Virgili, Tarragona Spain
Curr Opin Crit Care 13:45-50. 2007
..The inappropriate choice of antibiotics (in nearly one third of episodes) is the most important risk factor for death. Traditionally, a narrow-spectrum drug was used first, and the most potent drugs were reserved for subsequent use...
- PAI-1 gene: pharmacogenetic association of 4G/4G genotype with bleeding after cardiac surgery--pilot study
Gonzalo Sirgo
Intensive Care Department, Joan XXIII University Hospital, University Rovira i Virgili, Pere Virgili Health Institute, CIBER Enfermedades Respiratorias, Tarragona, Spain
Eur J Anaesthesiol 26:404-11. 2009
..To investigate whether the 4G/4G genotype of the PAI-1 gene is associated with bleeding after cardiac surgery and whether it may influence the use of antifibrinolytic drugs...
- Clinical approach to the patient with suspected ventilator-associated pneumonia
Loreto Vidaur
Critical Care Department, University Rovira and Virgili. Institut Pere Virgili, Joan XXIII University Hospital, Carrer Dr Mallafre Guasch 4, 43007 Tarragona, Spain
Respir Care 50:965-74; discussion 974. 2005
..Optimal management should be based on a strategy combining early high doses of an effective agent for a short period of time, which is then simplified in the light of microbiologic information...
- Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection
I Martin-Loeches
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias CIBERES, Tarragona, Spain
Intensive Care Med 37:272-83. 2011
..Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial...
- The spectrum of pneumococcal empyema in adults in the early 21st century
Joaquin Burgos
Infectious Diseases Department, Universitat Autonoma de Barcelona, Barcelona, Spain
Clin Infect Dis 53:254-61. 2011
..Our objective was to describe the risk factors for pneumococcal empyema in adults and to analyze the differences in the incidence, disease characteristics, and serotype distribution between the pre- and post-PCV7 eras...
- Pneumonia in the intensive care unit
Jordi Rello
Critical Care Department, Joan XXII University Hospital, University Rovira i Virgili, Taragona, Spain
Crit Care Med 31:2544-51. 2003
..To update the state-of-the-art on pneumonia in adult patients in the intensive care unit (ICU), with special emphasis on new developments in management...
- Nosocomial lung infections in adult intensive care units
Gonzalo Hernandez
Critical Care Department, 12, de Octubre University Hospital, University Complutense, Madrid, Spain
Microbes Infect 6:1004-14. 2004
..Nosocomial pneumonias are often difficult to treat due to antibiotic-resistant bacteria. Antibiotic policies are crucial in avoiding a progression in antibiotic resistance...
- Severe sepsis mortality prediction with relevance vector machines
Vicent J Ribas
SOCO Research Group, Llenguatges i Sistemes Informàtics, Universitat Politecnica de Catalunya, Barcelona, Spain
Conf Proc IEEE Eng Med Biol Soc 2011:100-3. 2011
..The reported results show that it outperforms in terms of accuracy alternative techniques currently in use, while simultaneously assessing the relative impact of individual pathology indicators...
- Effect of antibiotic diversity on ventilator-associated pneumonia caused by ESKAPE Organisms
Alberto Sandiumenge
Critical Care Department, Joan XXIII University Hospital, Carrer Dr Mallafre Guasch 4, 43007 Tarragona, Spain
Chest 140:643-51. 2011
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- Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia?: a survey based on the opinions of an international panel of intensivists
Jordi Rello
Critical Care Department, University Hospital Joan XXIII, University Rovira and Virgili, Tarragona, Spain
Chest 122:656-61. 2002
..Adherence to clinical practice guidelines is highly variable. Our objective was to review barriers to physicians' adherence to evidence-based guidelines (EBGs) for preventing ventilator-associated pneumonia (VAP)...
- New treatment options for infections caused by multiresistant strains of Pseudomonas aeruginosa and other nonfermenting gram-negative bacilli
Anna Sanchez
Critical Care Department, Vall d Hebron University Hospital, Barcelona, Spain
Semin Respir Crit Care Med 32:151-8. 2011
..Future options include immunotherapy or the continuous infusion of antibiotics. It is also important to emphasize the rational use of antibiotics to diminish the appearance of multiresistant pathogens...
- Bench-to-bedside review: Therapeutic options and issues in the management of ventilator-associated bacterial pneumonia
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, Institut Pere Virgili, Tarragona, Spain
Crit Care 9:259-65. 2005
..More active, less toxic antibacterial agents are still needed, in particular to combat problematic pathogens such as multiresistant Gram-negative bacilli and resistant Gram-positive organisms (e.g. methicillin-resistant S aureus)...
- Etiology of ventilator-associated pneumonia
Jordi Rello
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili, Carrer Dr Mallafre Guasch 4, Tarragona 43007, Spain
Clin Chest Med 26:87-95. 2005
..The discussion herein analyzes these aspects, placing particular emphasis on risk factors, attributable mortality, resistance, and the implications for management...
- Effects of high-dose of intravenous immunoglobulin and antibiotics on survival for severe sepsis undergoing surgery
Alejandro Rodriguez
Intensive Care Department of Joan XXIII University Hospital University Rovira and Virgili and Institut Pere Virgili, Tarragona, Spain
Shock 23:298-304. 2005
..We conclude that IVIG administration, when used in combination with adequate antibiotics, improved the survival of surgical ICU patients with intra-abdominal sepsis. The initial choice of antibiotic has a dramatic impact on outcome...
- Oral care practices in intensive care units: a survey of 59 European ICUs
Jordi Rello
Joan XXIII University Hospital, Critical Care Department, Mallafre Guasch 4, 43007 Tarragona, Spain
Intensive Care Med 33:1066-70. 2007
..To explore the type and frequency of oral care practices in European ICUs and the attitudes, beliefs, and knowledge of health care workers...
- Ventilator-associated pneumonia: issues related to the artificial airway
Emili Diaz
Critical Care Department, University Rovira and Virgili. Institut Pere Virgili, Joan XXIII University Hospital, Carrer Dr Mallafre Guasch 4, 43007 Tarragona, Spain
Respir Care 50:900-6; discussion 906-9. 2005
..As many studies suggest that incidence of VAP is highly dependent on the strategies of airway management, health care workers should be alerted to issues related to the artificial airway...
- Healthcare-associated infections. A useful concept?
Manel Lujan
Pneumology Service, Hospital de Sabadell, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell, Spain
Curr Opin Crit Care 15:419-24. 2009
..Although described originally in bacteremia, the concept has also been applied to other infections such as pneumonia and endocarditis...
- Antibiotic dosing in multiple organ dysfunction syndrome
Marta Ulldemolins
Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, QLD, Australia
Chest 139:1210-20. 2011
..Thereafter, maintenance dosing must be guided by drug clearance and adjusted to the degree of organ dysfunction...
- Diagnosis of ventilator-associated pneumonia: is there a gold standard and a simple approach?
Thiago Lisboa
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili, Institut Pere Virgili, CIBER Enfermedades Respiratorias, Tarragona, Spain
Curr Opin Infect Dis 21:174-8. 2008
..Recent findings in diagnosis are reviewed here...
- Management of ventilator-associated pneumonia
Emili Diaz
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias, Carrer Mallafre Guasch 4, Tarragona 43007, Spain
Infect Dis Clin North Am 23:521-33. 2009
..In recent years, a more dynamic approach has evolved, updating local epidemiology, evaluating VAP and diagnostic tools every day, and assessing host response using clinical and biochemical parameters...
- Association between 4G/5G polymorphism of the plasminogen activator inhibitor 1 gene with stroke or encephalopathy after cardiac surgery
Gonzalo Sirgo
Intensive Care Department, Joan XXIII University Hospital, University Rovira i Virgili, Institut Pere Virgili, Mallafre Guasch N 4, 43007, Tarragona, Spain
Intensive Care Med 32:668-75. 2006
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- The simple and the simpler in pneumonia diagnosis
Thiago Lisboa
Critical Care Department, Joan XXIII University Hospital, University Rovira and Virgili, Institut Pere Virgili, CIBERes Enfermedades Respiratorias, Carrer Mallafre Guasch, 4 43007, Tarragona, Spain
Crit Care 11:140. 2007
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- Emerging drugs for pneumococcal pneumonia
Vicenc Falco
Infectious Diseases Department, Hospital Universitari Vall d Hebron, Universitat Autonoma de Barcelona, Spain
Expert Opin Emerg Drugs 16:459-77. 2011
..Fluorquinolones constitute an excellent alternative therapy. Patients with shock or severe sepsis should probably receive combination therapy with β-lactams plus a macrolide due to its immunomodulatory effect...
- Top ten list in antibiotic policy in the ICU
Emili Diaz
Critical Care Department, Joan XXIII University Hospital, Tarragona, Spain
Chest 122:712-4. 2002
- Prevention of infection in the intensive care unit: current advances and opportunities for the future
Carmen Lorente
Critical Care Department, University Hospital Joan XXIII, University Rovira and Virgili, Tarragona, Spain
Curr Opin Crit Care 8:461-4. 2002
..Potential measures of control should focus on the patient, the microorganisms, and the device. A number of recent studies addressing these issues have been published and will be reviewed in this article...
- Effect of enriched thioglycolate on direct examination of respiratory specimens and guiding initial empirical therapy in intubated patients with pneumonia: a prospective, randomized study
Jordi Rello
Intensive Care Department, Hospital de Sabadell, Sabadell, Barcelona, Spain
Crit Care Med 30:311-4. 2002
..5% of samples transported in saline solution (p <.05). CONCLUSION: When protected specimen brush samples are obtained, thioglycolate may contribute to early identification of the pathogen and may guide the initial empirical therapy...
