Intensive care medicine
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Intensive care medicine · Apr 2010
Soluble ST2 plasma concentrations predict mortality in severe sepsis.
Patients with sepsis-after surviving the initial hyperinflammatory phase-display features consistent with immunosuppression, including hyporesponsiveness of immunocompetent cells to bacterial agents. Immunosuppression is thought to be facilitated by negative regulators of toll-like receptors, including membrane-bound ST2. We investigated the release of soluble ST2 (sST2), a decoy receptor that inhibits membrane-bound ST2 signaling, during sepsis. ⋯ Sepsis results in sustained elevation of serum sST2 levels, which correlates with disease severity and mortality.
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Intensive care medicine · Apr 2010
Chapter 1. Introduction. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.
In December 2007, the European Society of Intensive Care Medicine established a Task Force to develop standard operating procedures (SOPs) for operating intensive care units (ICU) during an influenza epidemic or mass disaster. ⋯ The draft SOPs serve as benchmarks for emergency preparedness and response of ICUs to emergencies or outbreak of pandemics.
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Intensive care medicine · Apr 2010
Noninvasive and invasive ventilation in acute respiratory failure associated with bronchiectasis.
To describe the outcomes of patients with bronchiectasis and acute respiratory failure (ARF) treated with noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) after a failure of conservative measures, and to identify the predictors of hospital mortality and NIV failure. ⋯ The hospital mortality of patients with bronchiectasis and ARF approximates 25% and is predicted by the APACHE II score. When selectively applied, NIV fails in one-third of the patients, and this is predicted by hypoxemia. Our findings call for randomised controlled trials to compare NIV versus IMV in such patients.
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Intensive care medicine · Apr 2010
Editorial CommentThe long way of biomarkers: from bench to bedside.
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Intensive care medicine · Apr 2010
Review Meta AnalysisProne ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis.
Prone position ventilation for acute hypoxemic respiratory failure (AHRF) improves oxygenation but not survival, except possibly when AHRF is severe. ⋯ Prone ventilation reduces mortality in patients with severe hypoxemia. Given associated risks, this approach should not be routine in all patients with AHRF, but may be considered for severely hypoxemic patients.