Critical care : the official journal of the Critical Care Forum
-
Randomized Controlled Trial
Norepinephrine weaning in septic shock patients by closed loop control based on fuzzy logic.
The rate of weaning of vasopressors drugs is usually an empirical choice made by the treating in critically ill patients. We applied fuzzy logic principles to modify intravenous norepinephrine (noradrenaline) infusion rates during norepinephrine infusion in septic patients in order to reduce the duration of shock. ⋯ Our study has shown a reduction in norepinephrine weaning duration in septic patients enrolled in the fuzzy group. We attribute this reduction to fuzzy control of norepinephrine infusion.
-
Multicenter Study
Acute lung injury and the acute respiratory distress syndrome in Ireland: a prospective audit of epidemiology and management.
The aim of this study was to describe the epidemiology and management of acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) in Ireland. ⋯ The incidence of ALI/ARDS is high and is associated with significant mortality. Protective lung ventilation is used commonly throughout participating centres. With low tidal volume ventilation, the degree of hypoxaemia is associated with outcome. These data will inform future multicentre clinical trials in ALI/ARDS in Ireland.
-
Comparative Study
A quality assessment of genetic association studies supporting susceptibility and outcome in acute lung injury.
Clinical observations and animal models provide evidence that the development of acute lung injury (ALI), a phenomenon of acute diffuse lung inflammation in critically ill patients, is influenced by genetic factors. Association studies are the main tool for exploring common genetic variations underlying ALI susceptibility and/or outcome. We aimed to assess the quality of positive genetic association studies with ALI susceptibility and/or outcome in adults in order to highlight their consistency and major limitations. ⋯ Although the quality of association studies seems to have improved over the years, more and better designed studies, including the replication of previous findings, with larger sample sizes extended to population groups other than those of European descent, are needed for identifying firm genetic modifiers of ALI.
-
Comparative Study
Circuit life span in critically ill children on continuous renal replacement treatment: a prospective observational evaluation study.
One of the greatest problems with continuous renal replacement therapy (CRRT) is early coagulation of the filters. Few studies have monitored circuit function prospectively. The purpose of this study was to determine the variables associated with circuit life in critically ill children with CRRT. ⋯ Circuit life span in CRRT in children is short but may be increased by the use of hemodiafiltration, higher heparin doses, and filters with a high surface area.
-
All original research contributions published in Critical Care in 2007 in the field of respirology and critical care medicine are summarized in this article. Fifteen papers were grouped in the following categories: acute lung injury and acute respiratory distress syndrome, mechanical ventilation, ventilator-induced lung injury, imaging, and other topics.