Critical care : the official journal of the Critical Care Forum
-
Septic shock remains an important issue for critical care physicians. Despite significant advances in the knowledge of its pathophysiology, new effective therapeutic approaches have yet to emerge. ⋯ In a recent study, Katharina Mederle and colleagues explored the impact of angiotensin 1 receptor-associated protein 1 (Arap1) deficiency on vascular hyporesponsiveness in an experimental model of septic shock. The authors demonstrate that experimental septic shock downregulates Arap1 expression, which in turn contributes to vascular hyporesponsiveness to angiotensin II.
-
Prediction of invasive candidal infection in critically ill patients with severe acute pancreatitis.
Patients with severe acute pancreatitis are at risk of candidal infections carrying the potential risk of an increase in mortality. Since early diagnosis is problematic, several clinical risk scores have been developed to identify patients at risk. Such patients may benefit from prophylactic antifungal therapy while those patients who have a low risk of infection may not benefit and may be harmed. The aim of this study was to assess the validity and discrimination of existing risk scores for invasive candidal infections in patients with severe acute pancreatitis. ⋯ In this study the Candida Colonisation Index Score was the most accurate and discriminative test at identifying which patients with severe acute pancreatitis are at risk of developing candidal infection. However its low sensitivity may limit its clinical usefulness.
-
A simple cheap meningococcal sepsis prognostic score based on readily available, rapid, objective laboratory base excess and platelet count was developed and validated retrospectively. This BEP score should facilitate sepsis clinical trials, allowing study of the relevant human animal model.
-
Analysis of Chinese ICU staffing in relation to final outcome yields comparable results as those reported in Western ICUs. This underlines the general principle that we would all like to apply in our hospitals; that is, availability of knowledgeable staff that are adequately trained to recognize and treat an acutely deteriorating critically ill patient as soon as possible.