Current opinion in critical care
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Research priorities in critical care are increasingly focusing on long-term outcomes and prognosis for survivors of critical illness. This review will focus on long-term outcomes after acute renal failure. ⋯ The long-term survival after acute renal failure is poor. Yet, most survivors recover sufficient function to become independent from renal replacement therapy. While perceived health-related quality of life is good, survivors have a lower health-related quality of life compared with the general population. Further research is needed to explore the relationship between survival, markers of morbidity and costs after acute renal failure.
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Curr Opin Crit Care · Dec 2006
ReviewThe impact of endogenous triggers on trauma-associated inflammation.
Inflammation immediately starting after trauma is a consequence of an efficient host defense system that is not only capable of sensing exogenous and pathogen-derived danger signals, but also endogenous, multifunctional alarm signals, which both can initiate an inflammatory response. ⋯ In addition to improved insights into the regulation of traumatic inflammation and the etiology of the systemic inflammatory response syndrome, some endogenous immune triggers seem to have the potential to serve as novel biomarkers in predicting post-traumatic complications.
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Curr Opin Crit Care · Dec 2006
ReviewThe perspective of families of the critically ill patient: their needs.
An appreciation of a family's difficult experience in dealing with their critically ill loved ones has created the concept of 'family-centered care'. The purpose of this paper is to review the literature on the needs of the family during their intensive care unit experience. ⋯ Medical staff and administrators should recognize that families of critically ill patients have particular needs that help them cope with having their loved ones in an intensive care unit. Simple changes in philosophy and policy would greatly decrease the anxiety these families experience.
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Acute renal failure is a common complication of sepsis in the critically ill patient. Fluid resuscitation is considered a cornerstone for preservation of function in the septic kidney. This is generally based on the assumption that fluid therapy will restore and maintain adequate renal blood flow. ⋯ Thus, it remains unclear how fluid therapy may affect renal blood flow in septic acute renal failure. Further, there is new evidence to imply that the choice, timing and amount of fluid used for resuscitation in sepsis may have a direct impact on kidney function. Thus, in this editorial, we consider the relevant literature and more recent insights into the effect of fluid resuscitation on the septic kidney.