Critical care : the official journal of the Critical Care Forum
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The aim of this study was to investigate the effects of levosimendan on rodent septic shock induced by cecal ligation and puncture (CLP). ⋯ In this clinically relevant model of septic shock induced by fecal peritonitis, the administration of levosimendan had beneficial effects on haemodynamic variables, liver and kidney dysfunction, and metabolic acidosis. (1) Lower levels of interleukin-1β, nitric oxide and superoxide, (2) attenuation of iNOS and caspase-3 expressions, and (3) decreases of neutrophil infiltration by levosimendan in peritonitis-induced sepsis animals suggest that anti-inflammation and anti-apoptosis effects of levosimendan contribute to prolonged survival.
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Comparative Study
Lung injury during non-invasive synchronized assist versus volume control in rabbits.
Experimental work provides insight into potential lung protective strategies. The objective of this study was to evaluate markers of ventilator-induced lung injury after two different ventilation approaches: (1) a "conventional" lung-protective strategy (volume control (VC) with low tidal volume, positive end-expiratory pressure (PEEP) and paralysis), (2) a physiological approach with spontaneous breathing, permitting synchrony, variability and a liberated airway. For this, we used non-invasive Neurally Adjusted Ventilatory Assist (NIV-NAVA), with the hypothesis that liberation of upper airways and the ventilator's integration with lung protective reflexes would be equally lung protective. ⋯ In experimental acute lung injury, NIV-NAVA is as lung-protective as VC 6 ml/kg with PEEP.
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Post-traumatic stress disorder (PTSD) is a common complication of an ICU admission. Rarely is there a continuation of care, which is aimed at screening for and treating this debilitating disease. Current treatment options for PTSD are held back by inconsistent efficacy, poor evidence, and a lack of understanding of its psychopathology. ⋯ The rapid uptake of new techniques, aimed at reducing PTSD after ICU admission, is necessary to maximize the quality of care given to patients. Increasingly, the realization that the role of intensive care specialists may extend beyond the ICU is changing clinical practice. As this field advances, intensivists and psychiatrists alike must collaborate by using the latest psychopharmacology to treat their patients and combat the psychological consequences of experiencing the extremes of physiological existence.