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The measurement of B-type natriuretic peptide (BNP) is recommended for the diagnosis of decompensated heart failure, the prognosis of chronic heart failure is worse if BNP is increased and studies suggest that...
Acidosis is associated with poor outcome in critical illness. However, acidosis - both hypercapnic and metabolic - has direct effects that can limit tissue injury induced by many causes. There is also a clear ...
Karakitsos and coworkers, in this journal, reported further compelling evidence on the value of ultrasound in guiding internal jugular vein catheterization. In a large, prospective, randomized study of 900 pat...
Based on its pleiotropic effects, erythropoietin can decrease inflammation, oxidative stress, and apoptosis. Erythropoietin provides organ protection for the heart, brain, and kidney in diverse preclinical ani...
A recent observational study in a large cohort of critically ill patients confirms the association between hyperlactatemia and mortality. The mechanisms regulating the rates of lactate production and clearance...
ICU-acquired limb and respiratory muscle weakness is a common, serious ICU syndrome, increasing in frequency with prolonged ICU stay and sepsis. A systematic approach facilitates precise localization of...
Over the past years there has been a significant decrease in mortality and morbidity in patients suffering from severe burns due to improved burn wound management and approaches in critical care. Survival is n...
Cardiovascular failure is one of the central therapeutic problems in patients with severe infection. Although norepinephrine is a potent and, in most cases, highly effective vasopressor agent, very high dosage...
The role of oxidative stress in regulating transcription factors and specific gene responses in critical illness is a new and emerging area. A better understanding of the proinflammatory oxidant stimuli of rea...
This article is part of a Supplement: Volume 15 Supplement 3
Recent papers discussed include two large, multicentre, high-positive end-expiratory pressure trials in acute lung injury and reflects upon the usefulness of such trial designs. Further papers considered inclu...
In the present commentary I review some current therapeutic debates. Is noninvasive ventilation going to become the gold standard for acute hypercapnic respiratory failure, and if we have to intubate and ventilat...
South Africa has undergone rapid changes in the political and social arenas since 1994. With new policy-makers in the Department of Health, the distribution of health care resources are being rationalised and ...
Dosing antibiotics in critically ill patients to achieve therapeutic concentrations is a significant challenge. The presence of septic shock and prescription of continuous renal replacement therapy introduces ...
Biguanide poisoning is associated with lactic acidosis. The exact mechanism of biguanide-induced lactic acidosis is not well understood. In the previous issue of Critical Care, Protti and colleagues demonstrated ...
Fluid resuscitation is widely used, and many patients are therefore exposed to plasma volume expanders. Among these, colloids, particularly hydroxyethyl starches, have been shown in recent experiments and clin...
Urinary indices are classically believed to allow differentiation of transient (or pre-renal) acute kidney injury (AKI) from persistent (or acute tubular necrosis) AKI. However, the data validating urinalysis ...
The TRIUMPH study, recently published in Journal of the American Medical Association, was a prospective randomized placebo-controlled trial testing the hypothesis that tilarginine (a non-specific inhibitor of nit...
When to commence renal replacement therapy (RRT) in the critically ill remains an unresolved issue. The study by Thakar and colleagues sheds some light on current practice through an international survey, demo...
Crystalloid and colloid solutions are used for resuscitation of the critically ill. One set of options, widely used today, are different preparations of hydroxyethyl starch (HES). However, the safety of HES re...
More than 30% of patients with pleural infection either die or require surgery. Drainage of infected fluid is the key to successful treatment, but intrapleural fibrinolytic therapy did not improve outcomes in an ...
Acidosis is one of the major consequences of hemodynamic instability in shock state patients directly associated with multiple organ failure evolution and death. Most studies on the hemodynamic consequences of...
The newly emerging human pathogen influenza A H7N9 represents a potentially major threat to human health. The virus was first shown to be pathogenic in humans in 2013, and outbreaks continue to occur in China ...
Respiratory muscle weakness is commonplace in critically ill patients, impairing the ability of those patients to breath, prolonging the need for ventilatory support, and increasing the likelihood of respirato...
A recent meta-analysis puts another nail in the coffin of a therapy that held great promise for management of acute respiratory distress syndrome. Two papers further highlight the growing controversy surroundi...
Acute respiratory failure is a life-threatening complication in cancer patients. During neutropenia, patients are at high risk for bacterial pneumonia or invasive fungal infections, when neutropenia is prolong...
The meta-analysis of Huang and coworkers failed to find any evidence for a protective effect of a decreased left ventricular (LV) ejection fraction (EF). These results have to be interpreted with caution since...
Post hoc analyses from the B-type natriuretic peptide for Acute Shortness of Breath Evaluation (BASEL)-II-ICU study suggest an association between beta-blocker usage at admission and improved mortality in patient...
Fluid therapy is fundamental to the acute resuscitation of critically ill patients. In general, however, early and appropriate goal-directed fluid therapy contributes to a degree of fluid overload in most if not ...
In critically ill patients, any acute organ injury is associated with a sudden change of circulating factors that may play a role in distant organ dysfunction through a complex cross-talk. In this issue, Virzì...
One of the holy grails of modern medicine, across a range of clinical sub-specialties, is establishing highly sensitive and specific biomarkers for various diseases. Significant success has been achieved in so...
Medical databases serve a critical function in healthcare, including the areas of patient care, administration, research and education. The quality and breadth of information collected into existing databases ...
Use of arginine vasopressin in the management of refractory vasodilatory shock has been associated with development of ischaemic skin lesions. Because of the increasing popularity of arginine vasopressin, it i...
Muscle relaxants in intensive care unit (ICU) patients are predominantly administered to facilitate intubation. The adverse effect profile of succinylcholine is such that its use in the ICU must be considered ...
Though the benefits of lung protective ventilation (LPV) in acute lung injury/acute respiratory distress syndrome (ALI/ARDS) have been known for more than a decade, widespread clinical adoption has been slow. ...
The original article was published in Critical Care 2020 24:28
This study was designed to evaluate the effect of nitric oxide(NO) on the management of neonates with severe persistent pulmonaryhypertension refractory to high-frequency oscillatory ventilation.
Critical Care