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Breast Surgery

Wednesday, 6 July 2011

Are we sedating more than just the brain?

Are we sedating more than just the brain? Critical Care 2011 15:163

Brummel, NE and Girard TD.

Heavy sedation in the ICU is associated with coma, delirium, and prolonged stays, but links between sedatives and non-brain organ failure have rarely been described. In a post-hoc analysis, Strom et al. explored associations between sedation and acute kidney injury among ICU patients randomized to one of two sedation strategies. The "no sedation" protocol was associated with less kidney injury, but methodologic limitations preclude firm conclusions regarding mechanisms underlying this association. This hypothesis-generating study warns that sedation may harm organs other than the brain during critical illness, a possibility that warrants careful study in the future.

Fever in septic ICU patients: friend or foe?

Fever in septic ICU patients: friend or foe? Critical Care 2011 15:222

Launey Y., et al.

In recent years, fever control in critically ill patients by medications and/or external cooling has gained widespread use, notably in patients suffering from neurological injuries. Nevertheless, such a strategy in septic patients is not supported by relevant data. Indeed, in response to sepsis, experimental and clinical studies argue that fever plays a key role in increasing the clearance of microorganisms, the immune response and the heat shock response. Moreover, fever is a cornerstone diagnostic sign in clinical practice, which aids in early and appropriate therapy, and allows physicians to follow the infection course. After discussing the physiological aspects of fever production, this review aims to delineate the advantages and drawbacks of fever in septic patients.

Gender related outcome difference is related to course of sepsis on mixed ICUs

Gender related outcome difference is related to course of sepsis on mixed ICUs: a prospective, observational clinical study. Critical Care 2011, 15:R151

Natchtigall I., et al.


Impact of gender on severe infections is in highly controversial discussion with natural survival advantage of females described in animal studies but contradictory to human data. This study aims to describe impact of gender on outcome in mixed intensive care units (ICU) with a special focus on sepsis. Conclusions: There were no differences in patients' outcome related to gender aspects on mainly surgical ICUs. However, for patients suffering from sepsis there is an increase of mortality related to the female sex.