Intensive care medicine
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Leukocytes have a fundamental role in innate and adaptive immunity, wound healing, tumour surveillance and in tissue remodelling. It is their function in the inflammatory response however that is of most interest to us in the intensive care setting. Over the last three decades we have gained significant insights into leukocyte activation, recruitment and mediator secretion and the contribution of these agents to both the onset and resolution of sepsis and inflammation. ⋯ This review will focus on two new facets of the innate immune system, the Toll family of proteins as the signal transduction element for endotoxin, and the antimicrobial peptides. These exemplify potential damaging and protective response elements but importantly neither are restricted to leukocytes. The capacity of cells and tissues other than the leukocytes to participate and even lead in the inflammatory responses will also be explored.
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Intensive care medicine · Jan 2000
Comprehensive critical incident monitoring in a neonatal-pediatric intensive care unit: experience with the system approach.
To examine the occurrence of critical incidents (CIs) in order to improve quality of care. ⋯ CIs are very common in pediatric intensive care. Knowledge of them is a precious source for quality improvement through changes in the system.
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To describe measurements of global oxygenation parameters, markers of splanchnic hypoperfusion and those of metabolic activity related to cellular energy production among critically ill children with septic shock. ⋯ In this study, trends in serum bicarbonate and lactate somewhat characterized the recovery of children with septic shock. Based on our data, it is unclear how other markers may have been used to modify therapy.
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Intensive care medicine · Jan 2000
Study of paediatric intensive care units in Spain. Spanish Society of Paediatric Intensive Care.
To describe the organisation of paediatric intensive care units in Spain and the medical assistance provided during 1996. ⋯ In Spain, paediatric intensive care is principally performed by specialised paediatricians. Although the general results for 1996 are similar to those of other European countries, efficiency studies are necessary to plan and re-organise the paediatric intensive care units in Spain.
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Intensive care medicine · Jan 2000
Comment Letter Comparative StudyPreliminary data: PIM vs PRISM in infants and children post cardiac surgery in a UK PICU.