Paper reports overview The many guises of respiratory support, microalbuminuria and delirium 英文参考文献.docVIP

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Paper reports overview The many guises of respiratory support, microalbuminuria and delirium 英文参考文献.doc

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Paper reports overview The many guises of respiratory support, microalbuminuria and delirium 英文参考文献

Available online /content/6/2/177 Commentary Paper reports overview: The many guises of respiratory support, microalbuminuria and delirium Jonathan Ball Lecturer in Intensive Care Medicine, St George’s Hospital Medical School, London, UK Correspondence: Jonathan Ball, j.ball@sghms.ac.uk Critical Care 2002, 6:177-178 Published online: 14 March 2002 This commentary reflects on the paper reports published in the Critical Care Forum between 9 January and 9 March 2002 College Hospital Liver team have demonstrated that arterial blood lactate measurements on admission and after fluid resuscitation in patients with paracetamol-induced acute liver failure, accurately identifies those patients who will require transplantation [11]. The last few months have seen a variety of important and thought provoking studies published. Sedation Respiratory medicine Delirium is a common but under recognised problem in ICU. Ely and colleagues have aided identification and February saw the publication of the large scale Australian ALI/ARDS epidemiology study [1] which found an incidence of ~30 cases per 100,000 population per annum and a 28 day mortality of ~30%, larger and smaller respectively than previous studies. Two closely related studies of randomly variable tidal volume ventilation in animal models of ARDS both reported positive findings in terms of gas exchange for this “re-discovered” ventilatory strategy [2, 3], and discuss their findings in light of the success of the low tidal volume strategy of ARDSnet fame [4]. Basic research has also thrown light onto the phenomenon of diaphragm dysfunction in sepsis and the protective effects of mechanical ventilation [5]. In the clinical arena, a large observational study of non- invasive ventilation (NIV) has produced a useful set of predictors of failure of this intervention (see paper report) [6]; in addition the BTS guidelines for NIV have just been published [7]. The enthusiasm for D-dimer quantitation