1,721,150 research outputs found
Hemadsorption in cardiac surgery: myth against reality
No full textCardiopulmonary bypass (CPB) surgery determines an unpredictable activation of a systemic inflammatory response induced by extrinsic and intrinsic factors.once activated by the extracorporeal circuit, this may lead to a dysregulation of inflammatory homeostasis, with increased levels of both pro-inflammatory — interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) — and anti-inflammatory — IL-6, IL-8, IL-10 — plasma mediators. Both an excessive increase of pro-inflammatory plasma cytokines and an imbalance of pro- and anti-inflammatory mediators seem predictive for postoperative organ dysfunction and major complications, such as postoperative infection rates, mechanical ventilation need, prolonged postoperative course, thus for an unfavorable outcome. The elimination of both pro- and anti-inflammatory cytokine is supposed to reduce not only the inflammatory response but also the eventual immune imbalance; indeed, small molecules as cytokines may be eliminated by adsorption depending on their plasma concentration using the hemadsorption technique, with a possible improvement of cardiovascular function
Are we ready for automated optimal cerebral perfusion pressure?
Full text linkSevere traumatic brain injury (TBI) may determine cerebral autoregulation derangements and cerebral blood flow (CBF) might become dependent on cerebral perfusion pressure (cPP). indeed, in healthy individuals CBF is adjusted by means of cerebral vessel vasodilatation and vasoconstriction, the so- called cerebral pressure autoregulation: the uninjured brain physiologically responds to variations in cerebral perfusion pressure (cPP) through constant modifications of CBF and vascular resistances
Why are you so tired after surgery?
No full textPathophysiology, incidence and evolution of post-operative fatigu
Should we measure immunoglobulin levels in septic patients?
No full textCommentLetterSCOPUS: le.jinfo:eu-repo/semantics/publishe
Cooling is hard on the heart: Which dose after cardiac arrest?
No full textSCOPUS: ed.jinfo:eu-repo/semantics/publishe
Is two (antibiotics) better than one?
No full textThe use of antibiotic therapy combining at least two drugs remains controversial in patients with severe sepsis and septic shock. Some studies have suggested an improvement in patients' outcome with combination therapy over monotherapy, especially in those patients with expected mortality exceeding 25%. Nevertheless, a recent large randomized multicentric clinical trial, comparing the effects of meropenem and moxifloxacin to meropenem alone on the occurrence of sepsis-related organ dysfunction, found no significant advantage for combination therapy. Also, mortality rates were similar at 28 days and at 90 days in both groups. Considering some opposite observations coming from other recent non-randomized studies, we aimed to discuss the raisons of these conflicting findings on antimicrobials combination in patients with severe sepsis and septic shock.Journal Articleinfo:eu-repo/semantics/publishe
Refractory septic shock: Who and how should we purify?
No full textSCOPUS: ed.jinfo:eu-repo/semantics/publishe
Editorial comment to intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery: guidelines of the German society of Anaesthesiology and Intensive care medicine in collaboration with the German Association of the Scientific medical societies
No full textIn this issue, the German Society of Anaesthesiology and
Intensive Care Medicine in collaboration with the German
Association of the Scientific Medical Societies provide
guidelines on intraoperative haemodynamic monitoring and
management of adults having non-cardiac surgery.
The document brings together a broad variety of data
regarding perioperative haemodynamic management.
Although a wide range of studies have been covered, no
systematic literature search was conducted, and the methodology
for appraising the evidence and formulating the recommendations
is not described. Therefore, these guidelines
should be viewed as a consensus of expert opinions, with
questions identified by anaesthesiologists from three German
university hospitals
What have we learned from the surviving sepsis campaign?
No full textThe surviving Sepsis Campaign (SSC) was an initiative of the European Society of Intensive Care Medicine, the International Sepsis Forum and the Society of Critical Care Medicine. It was developed with the aim of improving the diagnosis and the treatment of sepsis. Some years after the Authors reflect on what the Surviving Sepsis Campaign has taught us. First of all the SSC has shown that it is possible to raise awareness among physicians and lay persons of an important disease process. The development of sespis bundles has helped promote discussion of the optimal approach to sepsis management and has introduce some degree of uniformity to the process of treating patients with severe sepsis. It has encouraged a more standardised approach to patient management at a global level, in particular in those hospitals in which patient care is substandard
Intensive care medicine curricula in Europe: docendo discimus
No full textIntensive care medicine curricula across Europ
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