2,833 publications from this institution
The MostCare system provided measurements of CO that were comparable to ThD-CO in patients assisted with an intraaortic balloon pump. The reliability of the MostCare system is not significantly affected by changes in arterial waveform morphology caused by inflation and deflation of the intraaortic balloon pump.
Just imagine this possible scenario: it is summer 2020 and our intensive care unit (ICU) is full of patients with COVID-19 and severe respiratory failure as a result of the newly described coronavirus, SARS-CoV-2 [1-3]. We have decreased virtually all the other activities in the hospital, so that there are not many critically ill patients with other problems. We have cancelled all non-urgent (and in fact some urgent) surgical cases, including cardiac surgery and neurosurgery cases that usually come through our Department.
It has been suggested that gut hypoxia is important in the development of multiple-organ failure, by triggering increased mediator release, and through altered gut mucosal permeability leading to increased bacterial translocation. Studies generally show that the gut is at risk during circulatory failure, as there is often redistribution of blood flow to other more vital organs. Splanchnic blood flow may not fall in all cases of acute circulatory failure, but an imbalance between oxygen demand and the level of oxygen supply can result in regional ischemia. In septic shock this may be exacerbated by an increase in oxygen demand and alterations in oxygen extraction. If the resultant gut hypoxia is indeed related to multiple-organ failure, then by improving, or at least maintaining, splanchnic blood flow we may be able to improve the associated high mortality rates. Many ways of achieving this have been, and are still being, investigated, but at present the only established methods are adequate fluid administration with the use of adrenergic agents. Early enteral nutrition is also important to maintain gut function.
info:eu-repo/semantics/published
Sepsis results from the activation of a complex cascade of mediators, an appropriate and necessary body response to infection or insult which can, however, become excessive and detrimental to the host. When the immunological host response is not well controlled, it may lead to multiple organ failure and death. This manuscript reviews the epidemiology and the major factors involved in the development of sepsis, and considers a number of therapeutic interventions that may help to better control the septic process and the related development of multiple organ failure.
