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We conducted this study to evaluate the feasibility of implementing an internet-linked handheld computer procedure logging system in a critical care training program.
The second part of this review addresses the treatment and prognosis of the vasculitides Wegener's granulomatosis, microscopic polyangiitis, Churg–Strauss syndrome and polyarteritis nodosa. Treatment regimens ...
The first part of this review addresses the diagnosis and differential diagnosis of the primary vasculitides Wegener's granulomatosis, microscopic polyangiitis, Churg–Strauss syndrome and polyarteritis nodosa....
Rapid and efficient cooling is the most important therapeutic objective in patients with heat stroke (HS). This article reviews the mechanism of action and rationale for the use of dantrolene as a potential su...
Extubation failure is an outcome of increasing importance but nearly all studies have been conducted in academic settings. The article by Seymour and colleagues demonstrates that extubation failure is an outco...
During sepsis the endocrine, immune and nervous systems elaborate a multitude of biological responses. Little is known regarding the mechanisms responsible for the final circulating erythropoietin (EPO) and re...
For many patients optimal perioperative care may require little or no additional medical management beyond that given by the anaesthetist and surgeon. However, the continued existence of a group of surgical pa...
Current protective lung ventilation strategies commonly involve hypercapnia. This approach has resulted in an increase in the clinical acceptability of elevated carbon dioxide tension, with hypoventilation and...
Critical care is both expensive and increasing. Emergency department (ED) management of critically ill patients before intensive care unit (ICU) admission is an under-explored area of potential cost saving in ...
This review focuses on mechanical ventilation strategies that allow unsupported spontaneous breathing activity in any phase of the ventilatory cycle. By allowing patients with the acute respiratory distress sy...
Chronic alcoholic patients have a threefold to fourfold increased risk for developing a severe infection or septic shock after surgery, which might be due to altered immune response. The aim of this outcome ma...
A recent study by Bruhn and colleagues, discussed here, confirms that even high levels of positive end-expiratory pressure (PEEP) – up to 20 cmH2O – may be applied in conditions of moderate acute respiratory dist...
Positive end-expiratory pressure (PEEP) improves oxygenation and can prevent ventilator-induced lung injury in patients with acute respiratory distress syndrome (ARDS). Nevertheless, PEEP can also induce detri...
Three new articles in Critical Care add to an expanding body of information on the epidemiology of severe sepsis. Although there have been a range of approaches to estimate the incidence of severe sepsis, most st...
Carbon dioxide has been monitored in the body using a variety of technologies with a multitude of applications. The monitoring of this common physiologic variable in medicine is an illustrative example of the ...
To evaluate and compare the peri-operative and postoperative complications of the two most frequently used percutaneous tracheostomy techniques, namely guide wire dilating forceps (GWDF) and Ciaglia Blue Rhino...
Infection is an important complication in cancer patients, which frequently leads to or prolongs hospitalization, and can also lead to acute organ dysfunction (severe sepsis) and eventually death. While cancer...
Early recognition of sick patients with a poor prognosis, and the rapid institution of appropriate therapy are tenets of good medical management across all specialties. Here we highlight five recent papers tha...
There has been renewed interest in quantifying acid–base disorders in the intensive care unit. One of the methods that has become increasingly used to calculate acid–base balance is the Stewart model. This mod...
Clearance of pulmonary edema fluid is accomplished by active ion transport, predominantly by the alveolar epithelium. Various ion pumps and channels on the surface of the alveolar epithelial cell generate an o...
Acute lung injury (ALI) is a complex and devastating illness, often occurring within the setting of sepsis, and carries an annual mortality rate of 30–50%. Although the genetic basis of ALI has not been fully ...
Relative risk and odds ratio have been introduced in earlier reviews (see Statistics reviews 3, 6 and 8). This review describes the calculation and interpretation of their confidence intervals. The different c...
A young person presents with a highly malignant brain tumour with hemiparesis and limited prognosis after resection. She then suffers an iatrogenic cardiac and respiratory arrest that results in profound anoxi...
Respiratory tract obstruction due to a blood clot may result in life threatening ventilatory impairment. Ball valve blood clot obstructions of the airways are rare. A ball valve blood clot acts as a one-way va...
In order to improve the efficiency of heat moisture exchangers (HMEs), new hybrid humidifiers (active HMEs) that add water and heat to HMEs have been developed. In this study we evaluated the efficiency, both in ...
This randomised, open-label, observational, multicentre, parallel group study assessed the safety and efficacy of analgesia-based sedation using remifentanil in the neuro-intensive care unit.
The molecular adsorbents recirculating system (MARS®) is a form of artificial liver support that has the potential to remove substantial quantities of albumin-bound toxins that have been postulated to contribute ...
The effect of various airway management strategies, such as the timing of tracheostomy, on liberation from mechanical ventilation (MV) is uncertain. We tested the hypothesis that tracheostomy, when performed p...
The present review will cover the mechanisms of release and the potential pathophysiological role of different natriuretic peptides in critically ill patients. By focusing on the cardiovascular system, possibl...
Microcirculatory perfusion is disturbed in sepsis. Recent research has shown that maintaining systemic blood pressure is associated with inadequate perfusion of the microcirculation in sepsis. Microcirculatory...
Erythropoiesis usually fails during severe illness because of a blunting of the kidney–erythropoietin (EPO)–bone marrow axis. In this setting, clinical studies have shown that recombinant human erythropoietin ...
Metabolic acidosis is among the most common abnormalities seen in patients suffering from critical illness. Its etiologies are multiple and treatment of the underlying condition is the mainstay of therapy. How...
Consistent data about the incidence and outcome of sepsis in Latin American intensive care units (ICUs), including Brazil, are lacking. This study was designed to verify the actual incidence density and outcom...
N-terminal pro brain natriuretic peptide (NT-proBNP) is a cardiac biomarker that has recently shown to be of diagnostic value in a diagnosis of decompensated heart failure, acute coronary syndromes and other c...
Krishnan and colleagues have conducted a prospective clinical trial of a weaning strategy previously demonstrated to enhance clinical outcomes of mechanically ventilated patients. They draw conclusions quite d...
Trauma is the leading cause of death from age 1 to 34 years and is the fifth leading cause of death overall in the USA, with uncontrolled hemorrhage being the leading cause of potentially preventable death. Im...
This article is part of a Supplement: Volume 8 Supplement 2
Intraoperative autologous transfusions have been used for many years to avoid transmission of infections, especially in vascular surgery, where blood usage is considerable. Several autotransfusion devices exis...
This article is part of a Supplement: Volume 8 Supplement 2
Preoperative anemia in a surgical patient predisposes to poor outcomes and allogeneic blood transfusions. As an alternative to transfusions, pharmacologic management of preoperative anemia with recombinant hum...
This article is part of a Supplement: Volume 8 Supplement 2
Critically ill patients receive an extraordinarily large number of blood transfusions. Between 40% and 50% of all patients admitted to intensive care units receive at least 1 red blood cell (RBC) unit during t...
This article is part of a Supplement: Volume 8 Supplement 2
The quality and economy of critical care could both be improved if blood losses due to phlebotomy and sampling from indwelling catheters for unnecessary diagnostic testing were curtailed. Practice guidelines c...
This article is part of a Supplement: Volume 8 Supplement 2
The decision to transfuse a hospitalized patient must balance the known risks of transfusion with the need to provide adequate tissue oxygenation and the appropriate utilization of blood as a scarce resource. ...
This article is part of a Supplement: Volume 8 Supplement 2
The safety of the blood supply has been a concern over the past 20–30 years because of the transmission of infectious diseases. Blood is still routinely tested for viruses, and leukoreduction is an effective s...
This article is part of a Supplement: Volume 8 Supplement 2
During the past 20 years, the perceived value of blood transfusions has changed as it has become appreciated that transfusions are not without risk. Red blood cell transfusion has been associated with disease ...
This article is part of a Supplement: Volume 8 Supplement 2
Blood transfusions remain common practice in the critical care and surgical settings. Transfusions carry significant risks, including risks for transmission of infectious agents and immune suppression. Transmi...
This article is part of a Supplement: Volume 8 Supplement 2
Persons who suffer traumatic injury are likely to be transfused with considerable amounts of blood during initial resuscitation efforts. Oxygen-carrying solutions are currently in clinical testing as substitut...
This article is part of a Supplement: Volume 8 Supplement 2
Despite the increasing availability of data supporting more restrictive transfusion practices, the risks and benefits of transfusing critically ill patients continue to evoke controversy. Past retrospective an...
This article is part of a Supplement: Volume 8 Supplement 2
The formation of red blood cells (RBCs) in the bone marrow is regulated by erythropoietin in response to a cascade of events. Anemia in the intensive care unit can be caused by a host of factors. Patients in t...
This article is part of a Supplement: Volume 8 Supplement 2
Anemia is a common problem in critically ill patients. It is caused, in part, by blood loss related to phlebotomy for diagnostic testing, occult gastrointestinal bleeding, renal replacement therapies, surgical...
This article is part of a Supplement: Volume 8 Supplement 2
Critical Care