Critical care : the official journal of the Critical Care Forum
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Comment Letter Comparative Study
Concerns about the effectiveness of critical incident stress debriefing in ameliorating stress reactions.
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The 8th World Congress saw the presentation of several late-breaking findings, such as the role of insulin in reducing mortality, and technologies such as vital microscopy. There were heated debates for and against the role of gastric tonometry, enteral nutrition, extracorporeal membrane oxygenation, the question of 'closed' or 'open' intensive care units, and several others. The overall message was the need to study outcomes and practise intensive care in a sensitive and humane fashion.
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Randomized Controlled Trial Clinical Trial
Red blood cell transfusion does not increase oxygen consumption in critically ill septic patients.
Red blood cell (RBC) transfusion is commonly used to increase oxygen transport in patients with sepsis. However it does not consistently increase oxygen uptake at either the whole-body level, as calculated by the Fick method, or within individual organs, as assessed by gastric intra-mucosal pH. ⋯ Hemoglobin increase does not improve either global or regional oxygen utilization in anemic septic patients. Furthermore, RBC transfusion may hamper right ventricular ejection by increasing the pulmonary vascular resistance index.