Intensive care medicine
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Intensive care medicine · Apr 2009
Austrian validation and customization of the SAPS 3 Admission Score.
To test the prognostic performance of the SAPS 3 Admission Score in a regional cohort and to empirically test the need and feasibility of regional customization. ⋯ The SAPS 3 Admission Score's general equation can be seen as a framework for addressing the problem of outcome prediction in the general population of adult ICU patients. For benchmarking purposes, region-specific or country-specific equations seem to be necessary in order to compare ICUs on a similar level.
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Intensive care medicine · Apr 2009
Microvascular flow and tissue oxygenation after major abdominal surgery: association with post-operative complications.
To evaluate the relationship between global oxygen delivery (DO(2)I), microvascular flow and tissue oxygenation in patients who did and did not develop complications following major abdominal surgery. ⋯ In a group of patients with low DO(2)I following major abdominal surgery, microvascular flow abnormalities were more frequent in patients who developed complications. However, there were no differences in DO(2)I, cutaneous PtO(2) or red cell flux between the two groups. Impaired microvascular flow may be associated with the development of post-operative complications.
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Intensive care medicine · Apr 2009
Submission of clinical studies to ethics committees or clinical trials registers: the authors' point of view.
To evaluate the satisfaction of clinical scientists when submitting study drafts to an ethics committee/clinical trials register (CLINICALTRIALS, EUDRACT, ISRCTN) we conducted an online survey of 240 authors publishing in anesthesia/critical care medicine (A) or in major general medical (M) journals from January to December 2007. No statistical difference between groups A and M was seen with regard to the number of studies submitted to ethics committees or registered in various clinical trials registers. ⋯ The authors in both groups gave a positive score to the better transparency in scientific research resulting from introduction of the clinical trials registers (+2.4 in group A, +4.8 in group M). The results of our study indicate widespread author dissatisfaction when submitting a clinical trial to ethics committees or clinical trials registers.
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Intensive care medicine · Apr 2009
Increased circulating regulatory T cells (CD4(+)CD25 (+)CD127 (-)) contribute to lymphocyte anergy in septic shock patients.
Sepsis syndrome represents the leading cause of death in intensive care unit. Patients present features consistent with a decline in immune responsiveness potentially contributing to mortality. We investigated whether CD4(+)CD25(+) regulatory T cells (Treg) participate in the induction of lymphocyte anergy after sepsis. ⋯ The relative increase in circulating Treg might play a role in lymphocyte anergy described after septic shock and represent a standardizable surrogate marker of declining proliferative capacity after sepsis.
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Intensive care medicine · Apr 2009
Endotoxin-induced gene expression differences in the brain and effects of iNOS inhibition and norepinephrine.
We studied gene expression differences in brain homogenate, hippocampus, somatosensory cortex and cerebellum of rats suffering from sepsis-associated delirium and analyzed the effects of norepinephrine and 1,400 W (specific inhibitor of the inducible nitric-oxide synthase). ⋯ Strongest gene regulations were found within the hippocampus. Norepinephrine showed a tendency of having a proinflammatory influence, while 1,400 W had no clear-cut effect onto the gene expression level.