Seminars in thoracic and cardiovascular surgery
-
Semin. Thorac. Cardiovasc. Surg. · Jan 2006
ReviewMechanical ventilation and acute respiratory distress syndrome.
Acute respiratory distress syndrome continues to be a high-mortality condition. The role of mechanical ventilation remains primarily a supportive modality. ⋯ Animal and human investigations that culminated in the Acute Respiratory Distress Syndrome Network low tidal volume study are reviewed. Current controversies in the application of mechanical ventilation including the use of positive end-expiratory pressure, recruitment maneuvers, and high frequency oscillatory ventilation are also addressed.
-
Semin. Thorac. Cardiovasc. Surg. · Jan 2006
Glycemic control, diabetic status, and mortality in a heterogeneous population of critically ill patients before and during the era of intensive glycemic management: six and one-half years experience at a university-affiliated community hospital.
Hyperglycemia occurs commonly in acutely and critically ill patients and has been associated with adverse clinical consequences. An emerging body of literature describes the beneficial effects of intensive glycemic monitoring and treatment (tight glycemic control, or "TGC"). ⋯ Non-diabetics who sustained hyperglycemia had an especially high risk of mortality, and benefited greatly from treatment. Further investigations will be needed to identify the most appropriate glycemic targets for different populations of patients.