2,833 publications from this institution
Early alterations of red blood cell rheology are common in intensive care unit patients, especially in those with sepsis. Comorbidities (other than hematologic diseases) do not significantly influence these abnormalities. These alterations could contribute to the microcirculatory alterations observed in critically ill patients.
SOCIETY OF CRITICAL CARE MEDICINE 34TH CRITICAL CARE CONGRESS PHOENIX, ARIZONA, USA JANUARY 15-19, 2005: Poster Presentation: Clinical Science: Therapeutics II
info:eu-repo/semantics/published
Norepinephrine (noradrenaline) and dopamine are commonly used first-line vasopressor agents in the treatment of patients with septic shock. Recently increasing interest has focused on whether one or other of these agents is superior in terms of improving outcome. Studies have looked particularly at the possible local effects of the vasopressors on splanchnic circulation, because evidence suggests that this area is important in the development and maintenance of septic shock. However, the many studies performed have yielded conflicting data and there is, as yet, little evidence to support one drug over the other in terms of their splanchnic effects. Overall, though, dopamine has many assets that make it a good first-line drug when compared with norepinephrine, and these are highlighted in the present, brief commentary.
Ventilator-associated pneumonia (VAP) is a common nosocomial infection associated with considerable morbidity and mortality. Various risk factors for VAP have been identified and include the duration of ICU stay and of mechanical ventilation, a diagnosis of trauma, and severity of illness. Knowledge of these factors can promote early diagnosis and hence treatment. In addition to simple, but very effective, basic hygiene, different preventative strategies have been suggested, and can be divided into those that aim to limit airway colonization, and those that improve host defense mechanisms. Of the former, non-invasive ventilation is effective but not always applicable or available, nursing the patient in the semi-recumbent position is also associated with a reduced incidence of VAP but carries its own problems, stress ulcer prophylaxis remains controversial, and selective digestive decontamination is probably only relevant to certain subgroups of patients. Methods to improve host defense include early nutrition. Immunostimulatory therapies, such as interferon and granulocyte colony stimulating factor, require further research to confirm their place in the prevention or management of VAP.
info:eu-repo/semantics/published
Administration of oral talactoferrin was not associated with reduced 28-day mortality in patients with severe sepsis and may even be harmful.
Fazit Eine intravasale Bindung von Stickstoffmonoxid durch eine modifizierte Hämoglobinlösung führt im septischen Schock zu keiner Reduktion der Mortalität, sondern bei besonders schwer erkrankten Patienten sogar zu einer erhöhten Mortalität.
