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It has been brought to our attention that the seventh sentence from paragraph two of Recommendation 17 in our research article [1], published in February 2007, is incorrect. \n \n"A clinical trial with brain injury patients found that hypertonic saline reduces intracranial pressure more effectively than dextran solution with 20% mannitol" \n \nThis should read: \n \n"A clinical trial with brain injury patients found that hypertonic saline with dextran reduces intracranial pressure more effectively than 20% mannitol solution when compared in equimolar dosing"
In this review, we seek to highlight how critical illness and critical care affect longer-term outcomes, to underline the contribution of ICU delirium to cognitive dysfunction several months after ICU discharge, to give new insights into ICU acquired weakness, to emphasize the importance of value-based healthcare, and to delineate the elements of family-centered care. This consensus of 29 also provides a perspective and a research agenda about post-ICU recovery.
Fluid management strategies need to be guided by an understanding of the pathophysiologic mechanisms underlying fluid imbalance. In the hypovolaemic patient, reduced circulating blood volume and venous return and, in severe cases, altered tissue perfusion may initiate a cascade of pathophysiologic processes culminating in multiple organ failure. The objectives of fluid management are to maintain adequate blood pressure, tissue oxygenation and intravascular fluid volume. Both crystalloids and colloids can be useful for these purposes. In the hypovolaemic patient with normal pulmonary function, the use of colloids to maintain colloid osmotic pressure can limit the development of peripheral as well as pulmonary oedema. However, choice of fluid is less important in states of increased lung capillary permeability. Further evidence is needed to broaden understanding of the optimal roles for particular fluid management strategies. Experimental models can make an important contribution in gathering such evidence. Rigorous pharmacoeconomic studies are also needed to define the benefits and costs of differing fluid regimens.
Muscle tissue oxygenation, oxygen consumption and microvascular reactivity are globally unaltered by RBC transfusion in critically ill patients. However, muscle oxygen consumption and microvascular reactivity can improve following transfusion in patients with alterations of these variables at baseline.
info:eu-repo/semantics/published
The mechanism involved in the generation of cardiac output during cardiopulmonary resuscitation (CPR) are complex and still controversial. This article reviews the concepts of "cardiac pump" and "thoracic pump", which can both be implicated, before presenting the practical implications as well as the possibilities of development of new CPR techniques.
