Critical care medicine
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Critical care medicine · Dec 2007
Meta Analysis Comparative StudyImpact of passive humidification on clinical outcomes of mechanically ventilated patients: a meta-analysis of randomized controlled trials.
Previous meta-analyses reported advantages of passive (i.e., heat and moisture exchangers, or HMEs) compared with active (i.e., heated humidifiers, or HHs) humidifiers in reducing the incidence of ventilator-associated pneumonia, but they did not examine the effect of these devices on mortality, length of intensive care unit stay, and duration of mechanical ventilation. In addition, relevant data were recently published. ⋯ The available evidence does not support the preferential performance of either passive or active humidifiers in mechanical ventilation patients in terms of ventilator-associated pneumonia incidence, mortality, or morbidity.
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Critical care medicine · Dec 2007
Comment Review Meta AnalysisUse of polyclonal immunoglobulins as adjunctive therapy for sepsis or septic shock.
There is ongoing debate about the efficacy of polyvalent immunoglobulins as adjunctive therapy for sepsis or septic shock. Two meta-analyses by the Cochrane collaboration calculated a significant reduction in mortality. However, data of the largest study were missing in one, and a subset of four high-quality studies failed to show an effect in the other. To broaden the database, we performed a meta-analysis of all randomized controlled studies published so far. ⋯ Polyvalent immunoglobulins exert a significant effect on mortality in sepsis and septic shock, with a trend in favor of IgGAM.
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Critical care medicine · Dec 2007
Comment Comparative Study Clinical TrialHemodynamic improvement following levosimendan treatment in patients with acute myocardial infarction and cardiogenic shock.
Levosimendan, a novel inodilator, has been shown to improve hemodynamic function in patients with acute exacerbation of congestive heart failure. We wanted to determine the hemodynamic effects of levosimendan following ineffective conventional therapy (with catecholamines) in patients with cardiogenic shock following myocardial infarction. ⋯ Levosimendan infusion in cardiogenic shock following acute myocardial infarction improved cardiovascular hemodynamics without leading to hypotension.
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Critical care medicine · Dec 2007
Randomized Controlled TrialOverture for growth hormone: requiem for interleukin-6?
Music has been used for therapeutic purposes since the beginning of cultural history. However, despite numerous descriptions of beneficial effects, the precise mechanisms by which music may improve human well-being remain unclear. ⋯ Based on the effects of slow movements of Mozart's piano sonatas, we propose a neurohumoral pathway by which music might exert its sedative action. This model includes an interaction of the hypothalamic-pituitary axis with the adrenal medulla via mediators of the unspecific immune system