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Dehydroepiandrosterone (DHEA) and its sulphate (DHEAS) are pleiotropic adrenal hormones with immunostimulating and antiglucocorticoid effects. The present study was conducted to evaluate the time course of DHE...
In 1982, the author attended a lecture by Professor Joseph Civetta dealing with the concept that, at times, the goal of care should be comfort rather than cure, and that inappropriate care prolonged dying and ...
Problems with commissioning paediatric intensive care stem both from difficulties in recruitment and retention of nurses, and from incoherent or nonexistent national audit. Pyramidal career structures and patt...
This article is part of a Supplement: Volume 6 Supplement 2
This article is part of a Supplement: Volume 6 Supplement 2
This article is part of a Supplement: Volume 6 Supplement 2
This article is part of a Supplement: Volume 6 Supplement 2
This article is part of a Supplement: Volume 6 Supplement 2
This article is part of a Supplement: Volume 6 Supplement 2
A growing body of evidence indicates that survivors of intensive care have an impaired quality of life. It is not entirely clear from the available literature whether this impairment is a complication of criti...
Most physicians involved in intensive care consider lactate solely as a deleterious metabolite, responsible for high morbidity and bad prognosis in severe patients. For the physiologist, however, lactate is a ...
Multiple organ failure is the major problem in intensive care patients. The failure of the organ 'immune system' is frequently overlooked, however. In this issue the article by Angele and Faist provides an exc...
Treatment of sepsis is aimed at increasing both the duration and quality of survival. A long-term focus on quality of life (QoL) in clinical trial evaluations of sepsis care should be a priority.
The detection of endotoxemia may provide a clue to the cause of sepsis or may indicate translocation of endotoxin from the gastrointestinal tract. A reliable endotoxin activity assay (EAA) offers the potential...
Hemofiltration may modulate the inflammatory response in sepsis through a variety of mechanisms. We sought to distinguish clearance from adsorption as the principal mechanism responsible for reducing circulati...
Treatment of patients with severe sepsis with agents antagonising the effects of C5a has been proposed based on beneficial effects in animal experiments and in vitro studies demonstrating upregulation of the C5a ...
Following intravenous administration, vancomycin is poorly metabolized and is mainly excreted unchanged in urine. Total body clearance is thus dependent on the kidney, and is correlated with glomerular filtrat...
Great advances have been made in describing the intracellular pathways and genes that are activated by bacterial products. New definitions and therapies for sepsis will be based on such cellular and genetic al...
The purpose of this study was to note potential gynaecological risk factors leading to intensive care and to estimate the frequency, costs and outcome of management.
The glucose paradox of cerebral ischemia (namely, the aggravation of delayed ischemic neuronal damage by preischemic hyperglycemia) has been promoted as proof that lactic acidosis is a detrimental factor in th...
The ability of the isolated lung tissue to take up glucose and to release lactate is potentially similar to that of other body tissues. Nonetheless, when lung lactate exchange was assess in vivo in normal humans,...
The native kidney has a major role in lactate metabolism. The renal cortex appears to be the major lactate-consuming organ in the body after the liver. Under conditions of exogenous hyperlactatemia, the kidney...
Data obtained from net organ balance studies of glucose production lead to the classic view according to which glucose homeostasis is mainly ensured by the liver, and renal glucose production only plays a sign...
Part of Stephan Jakob's exhaustive review paper in the present issue of Critical Care deals with the notion that intestinal cellular energetics are deranged in sepsis, in terms not only of inadequate tissue perfu...
Despite decades of resuscitating patients with intravenous fluids in intensive care units, it is somewhat surprising that very little consensus exists regarding the type of fluid physicians should choose. Fact...
Several studies indicate that organ failure is the leading cause of death in surgical patients. An excessive inflammatory response followed by a dramatic paralysis of cell-mediated immunity following major sur...
Blood transfusions are commonly administered to critically ill patients, but deciding when to transfuse a particular patient is often difficult and necessitates careful consideration of both the potential bene...
In this prospective, randomized controlled study, we aimed to evaluate the effect of IgM-enriched immunoglobulin treatment on progression of organ failure and septic shock in patients with severe sepsis.
The present review introduces the notion of statistical power and the hazard of under-powered studies. The problem of how to calculate an ideal sample size is also discussed within the context of factors that ...
This review describes the microbiology, diagnosis and management of bacteremia caused by anaerobic bacteria in children. Bacteroides fragilis, Peptostreptococcus sp., Clostridium sp., and Fusobacterium sp. were t...
Based on several recently completed randomized controlled trials, cortisol replacement is likely to become a standard of care for vasopressor dependent septic shock. Further studies are needed in order to acco...
General outcome prediction models developed for use with large, multicenter databases of critically ill patients may not correctly estimate mortality if applied to a particular group of patients that was under...
Although numerous studies over the past 40 years have addressed this problem, initial graft failure is still a key question in clinical lung transplantation. As a possible tool to avoid and treat initial graft...
Lipopolysaccharide (endotoxin) from the cell wall of Gram-negative bacteria is a potent trigger for the release of host-derived inflammatory mediators. The relationship between endotoxaemia, Gram-negative infe...
The clinical syndrome of sepsis is common, increasing in incidence and responsible for as many deaths annually as ischaemic heart disease. Two recent interventional trials have demonstrated that early recognit...
To demonstrate the effects of combined inhaled nitric oxide and surfactant replacement as treatment for acute respiratory distress syndrome. This treatment has not previously been documented for reperfusion in...
This pro/con debate explores the ethical issues surrounding nonheart-beating organ donation (NHBD), a source of considerable controversy. It is estimated that NHBD can increase the number of organs available f...
The aim of this study was to investigate the haemodynamic changes that follow the appearance of pruritus during vancomycin administration.
Measuring cardiac output is of paramount importance in the management of critically ill patients in the intensive care unit and of 'high risk' surgical patients in the operating room. Alternatives to thermodil...
The aim of the study was to assess the prognostic importance of basal cortisol concentrations and cortisol response to corticotropin, and to determine the effects of physiological dose steroid therapy on morta...
In order to evaluate the complications and risk factors associated with peripheral arterial catheters used for haemodynamic monitoring, we reviewed the literature published from 1978 to 2001. We closely examin...
Critical Care