Journal of critical care
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Journal of critical care · Feb 2012
Hemodynamic effects of positive end-expiratory pressure during abdominal hyperpression: a preliminary study in healthy volunteers.
An increase in abdominal pressure induces an increase in left ventricular afterload under clinical conditions. We tested the hypothesis that positive end-expiratory pressure (PEEP) could reverse the hemodynamic consequences of abdominal hyperpression by opposing the increase in left ventricular afterload. ⋯ The increase in left ventricular afterload induced by MAST inflation can be efficiently reduced by the use of a moderate PEEP. Potential clinical applications in the abdominal compartment syndrome or in the setting of laparoscopic surgery should be developed.
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Journal of critical care · Feb 2012
Editorial CommentPalliative care in a neonatal intensive care unit.
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Journal of critical care · Dec 2011
Dynamic changes of matrix metalloproteinases and their tissue inhibitors in severe sepsis.
Little is known about the dynamic changes of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) in sepsis. Our aim was therefore to investigate the time course of MMPs and their inhibitors in patients experiencing severe sepsis. ⋯ Our research is the first follow-up study dealing with MMPs, TIMPs, and their ratios in severe sepsis. Our results indicate that MMPs and TIMPs may play a crucial role in severe sepsis, especially TIMP-1, MMP-9, and possibly TIMP-2, after an extensive study.
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Journal of critical care · Dec 2011
Acute Kidney Injury Network definition of contrast-induced nephropathy in the critically ill: incidence and outcome.
Contrast-induced nephropathy (CIN) has been extensively studied in the ward but only scarcely in intensive care unit (ICU) patients, even if they may be particularly prone to develop or to worsen acute kidney insufficiency. We aimed to measure the incidence of CIN in a large ICU population using the Acute Kidney Injury Network (AKIN) definition and to investigate its impact on patients' outcome. ⋯ Even if incidence varied greatly depending on the definition, CIN appeared frequent in our critically ill patients. The AKIN definition, independently associated with ICU mortality, may allow unifying diagnostic criteria to further evaluate this condition that impacts morbidity and mortality.