Critical care medicine
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Critical care medicine · May 2012
Review Meta AnalysisA systematic review and meta-analysis of clinical trials of thyroid hormone administration to brain dead potential organ donors.
To review all published clinical studies of thyroid hormone administration to brain-dead potential organ donors. ⋯ The findings of this systematic review do not support a role for routine administration of thyroid hormone in the brain-dead potential organ donor. Existing recommendations regarding the use of thyroid hormone in marginal donors are based on low-level evidence.
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Pediatric septic shock continues to be an important public health problem. Several investigative groups have applied genetic and genomic approaches as a means of identifying novel pathways and therapeutic targets, discovery of sepsis-related biomarkers, and identification of septic shock subclasses. This review will highlight studies in pediatric sepsis with a focus on gene association studies and genome-wide expression profiling. ⋯ Pediatric sepsis and septic shock are increasingly being studied by genetic and genomic approaches and the accumulating data hold the promise of enhancing our future approach to this ongoing clinical problem.
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Critical care medicine · May 2012
Sepsis-associated changes of the arachidonic acid metabolism and their diagnostic potential in septic patients.
Sepsis-associated changes of the arachidonic acid metabolism and the utility of arachidonic acid metabolites for the diagnosis of sepsis have been poorly investigated so far. Therefore, the primary objective of our study was to screen for differentially regulated arachidonic acid metabolites in septic patients using a lipopolysaccharide whole-blood model and to investigate their diagnostic potential. ⋯ Arachidonic acid metabolism is markedly affected in patients with sepsis. Our data suggest that the analysis of arachidonic acid metabolites in an in vitro whole blood activation model may be a promising approach for risk estimation in septic patients that has to be further evaluated in subsequent large-scale clinical studies.
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Critical care medicine · May 2012
Randomized Controlled TrialRight ventricular function during high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome.
To evaluate the effect of mean airway pressure under high-frequency oscillatory ventilation on right ventricular function. ⋯ In patients with mainly pulmonary acute respiratory distress syndrome, using high mean airway pressure under high-frequency oscillatory ventilation can worsen right ventricular function when compared with protective conventional mechanical ventilation, notably in patients in whom high-frequency oscillatory ventilation produced less alveolar recruitment of the posterior parts of the lungs. This study highlights the interest of monitoring right ventricular function during high-frequency oscillatory ventilation.