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Sleep disturbances are common in critically ill patients and have been characterised by numerous studies using polysomnography. Issues regarding patient populations, monitoring duration and timing (nocturnal v...
Why is the practice of intensive care so heterogenous? Uncertainty as to 'best practice', conservatism, and complacency may all contribute to our divergent management strategies. The need for further generalis...
Mitochondrial dysfunction may be causally related to the pathogenesis of organ failure in critically ill patients. Decreased mitochondrial DNA (mtDNA) levels have been associated with mitochondrial dysfunction...
Vasospasm is one of the leading causes of morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH). Radiographic vasospasm usually develops between 5 and 15 days after the initial hemorrhage,...
Intubation of the airway can lead to laryngotracheal injury, resulting in extubation failure from upper airway obstruction (UAO). A number of factors can help to identify patients who are at greatest risk for ...
Many studies have demonstrated that prompt appropriate treatment for the critically ill patient improves outcome. Moving patients to the best place for instituting care, however, is not always associated with ...
Experimental studies have demonstrated that dextran-70 reduces the leukocyte–endothelium interaction, but clinical evidence is still lacking. Our objective was to justify the anti-inflammatory effect of dextra...
Protective ventilatory strategies have been applied to prevent ventilator-induced lung injury in patients with acute lung injury (ALI). However, adjustment of positive end-expiratory pressure (PEEP) to avoid a...
A body of knowledge exists to suggest an association between nurse staffing and adverse patient outcomes. Hugonnet and colleagues add further evidence by linking nurse staffing to late-onset ventilator-associa...
Trauma is a leading cause of mortality and morbidity, with traumatic brain injury (TBI) and uncontrolled hemorrhage responsible for the majority of these deaths. Recombinant activated factor VIIa (rFVIIa) is b...
A recent study by Forceville and colleagues evaluated the effect of high-dose selenium administration as a treatment for septic shock. The study was negative and conflicts with existing clinical data regarding...
Biomarkers of sepsis could allow early identification of high-risk patients, in whom aggressive interventions can be life-saving. Among those interventions are the immunomodulatory therapies, which will hopefu...
Serum creatinine is a late marker of acute kidney injury (AKI). Urine neutrophil gelatinase-associated lipocalin (uNGAL) is an early marker of AKI, where the timing of kidney injury is known. It is unknown whe...
Caudwell Xtreme Everest (CXE) is a large healthy volunteer field study investigating human adaptation to environmental hypoxia. More than 200 individuals were studied at sea-level and in four laboratories on t...
Prospective medical decision-making through the use of advanced directives is encouraged and frequently helpful in guiding treatment for the critically ill. It is important to recognize the attendant shortcomi...
Tacrolimus is an important immunosuppressive drug for organ transplantation patients. It has a narrow therapeutic range, toxic side effects, and a blood concentration with wide intra- and interindividual varia...
Intra-abdominal hypertension is common in critically ill patients and is associated with increased severity of organ failure and mortality. The techniques most commonly used to estimate intra-abdominal pressur...
Acute kidney injury (AKI) is a common clinical problem with significant clinical and economic consequences. A number of studies point to a rising incidence of AKI in the hospital and in the intensive care unit...
We sought to determine and compare the effects of vasopressin, fluid resuscitation and saline placebo on haemodynamic variables and short-term survival in an abdominal vascular injury model with uncontrolled h...
In a recent meta-analysis, surfactant administration in paediatric acute respiratory failure was associated with improved oxygenation, reduced mortality, increased ventilator-free days and reduced duration of ...
Long-term outcome – mortality, morbidity and quality of life – is finally receiving attention in the field of intensive care research. A number of recent studies have focused on patient survival and kidney sur...
The clinical and economic burden of ventilator-associated pneumonia (VAP) is uncontested. We conducted the present study to determine whether low nurse-to-patient ratio increases the risk for VAP and whether t...
Early nutrition is recommended for patients with sepsis, but data are conflicting regarding the optimum route of delivery. Enteral nutrition (EN), compared with parenteral nutrition (PN), results in poorer ach...
Predicting whether a critically ill patient will survive intensive care treatment remains difficult. The advantages of a validated strategy to identify those patients who will not benefit from intensive care u...
We compared the effects of mechanical ventilation with a lower tidal volume (VT) strategy versus those of greater VT in patients with or without acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) ...
Premature circuit clotting is a major problem in daily practice of continuous renal replacement therapy (CRRT), increasing blood loss, workload, and costs. Early clotting is related to bioincompatibility, crit...
Withdrawal and limitation of life support in the intensive care unit is common, although how this decision is reached can be varied and arbitrary. Inevitably, the patient is unable to participate in this discu...
High-mobility group box-1 protein (HMGB1) has been known as a chromosomal protein for many years. HMGB1 has recently been shown to be a proinflammatory cytokine with a role in the immunopathogenesis of sepsis....
A single centre has reported that implementation of an intensive insulin protocol, aiming for tight glycaemic control (blood glucose 4.4 to 6.1 mmol/l), resulted in significant reduction in mortality in longer...
Recent evidence suggests that early, aggressive resuscitation in patients with septic shock reduces mortality. The objective of this survey was to characterize reported resuscitation practices of Canadian phys...
Today, computer-aided strategies in social sciences are an indispensable component of teaching programs. In recent years, microsimulation modeling has gained attention in its ability to represent predicted phy...
Sepsis is associated with the generation of oxygen free radicals and (lacking) decreased selenium plasma concentrations. High doses of sodium selenite might reduce inflammation by a direct pro-oxidative effect...
Prophylactic steroid therapy to reduce the occurrence of postextubation laryngeal edema is controversial. Only a limited number of prospective trials involve adults in an intensive care unit. The purpose of th...
The choice of induction agent for endotracheal intubation can have significant downstream effects, especially in critically ill patients. In a retrospective study, Ray and McKeown found that the choice of indu...
We evaluated the efficacy of and tolerance to mild therapeutic hypothermia achieved using an endovascular cooling system, and its ability to reach and maintain a target temperature of 33°C after cardiac arrest.
Sepsis is the main cause of morbidity and mortality in intensive care units and its early diagnosis is not straightforward. Many studies have evaluated the usefulness of various markers of infection, including...
In daily clinical practice the diagnosis of sepsis is imprecise and often delayed. In part, this is because the diagnosis is based on a clinical picture of signs and symptoms. This basis has significant implic...
Intensive care unit (ICU) costs account for up to 20% of a hospital's costs. We aimed to analyse the individual patient-related cost of intensive care at various hospital levels and for different groups of dis...
There is limited information on whether the incidence of acute kidney injury (AKI) in critically ill patients has changed over time and there is controversy on whether its outcome has improved.
Patients with sepsis suffer high morbidity and mortality. We sought to conduct a systematic review of the literature to evaluate the association between hemodynamic goals of therapy and patient outcomes.
This article is part of a Supplement: Volume 11 Supplement 3
This article is part of a Supplement: Volume 11 Supplement 3
This article is part of a Supplement: Volume 11 Supplement 3
This article is part of a Supplement: Volume 11 Supplement 3
Critical Care