Critical care medicine
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To present and discuss the rationale and results of clinical trials using antithrombin (AT) supplementation in patients with sepsis. ⋯ Together, these studies are consistent with the positive effect seen with AT supplementation in patients with severe sepsis. A multicenter phase III trial is currently in progress to definitively document its effect on mortality.
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Critical care medicine · Sep 2000
ReviewNew therapeutic implications of anticoagulation mediator replacement in sepsis and acute respiratory distress syndrome.
To examine the relationship between the coagulation and immune systems in sepsis and acute respiratory distress syndrome and to review published experimental and clinical studies that use anticoagulation mediator replacement strategies in these conditions. ⋯ Coagulation abnormalities are common in the critically ill. Early studies using anticoagulation mediator replacement in patients with sepsis have suggested beneficial effects on organ function and outcome. The results from larger, randomized controlled trials are eagerly anticipated.
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Critical care medicine · Sep 2000
Dynamic study of the distribution of microcirculatory blood flow in multiple splanchnic organs in septic shock.
To study dynamic distribution of microcirculatory blood flow in multiple splanchnic organs during septic shock; to test the hypothesis that changes in microcirculatory blood flow in splanchnic organs correlate with changes in regional flow during septic shock. ⋯ Changes in microcirculatory blood flow in the splanchnic organs are heterogeneous, both in early hypodynamic and in hyperdynamic septic shock, and cannot be predicted from changes in systemic or regional flows. Microcirculatory blood flow in the jejunal mucosa remains constant during early septic shock, whereas pancreatic blood flow decreases significantly more than regional flow.