Current opinion in critical care
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Curr Opin Crit Care · Oct 2004
ReviewNonlinear dynamics, complex systems, and the pathobiology of critical illness.
The review considers problems in critical illness and critical care in the context of complex systems science. Normal physiology is characterized by nonlinear dynamics, and it appears that the pathophysiology of critical illness alters those dynamics. ⋯ Physiologic dynamics in health and in critical illness appear to reflect complex, interconnected systems biology. Alterations in illness and during recovery may provide important clues to the underlying structure of the system. With knowledge of the structure, therapy could be better focused toward supporting both function and dynamics, offering hope for improved outcomes.
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Curr Opin Crit Care · Oct 2004
ReviewBayesian analysis, pattern analysis, and data mining in health care.
To discuss the current role of data mining and Bayesian methods in biomedicine and heath care, in particular critical care. ⋯ With the increasing availability of biomedical and health-care data with a wide range of characteristics there is an increasing need to use methods which allow modeling the uncertainties that come with the problem, are capable of dealing with missing data, allow integrating data from various sources, explicitly indicate statistical dependence and independence, and allow integrating biomedical and clinical background knowledge. These requirements have given rise to an influx of new methods into the field of data analysis in health care, in particular from the fields of machine learning and probabilistic graphical models.
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Curr Opin Crit Care · Oct 2004
ReviewInflammation and cardiovascular diseases: lessons that can be learned for the patient with cardiogenic shock in the intensive care unit.
In the past 12 years, atherosclerosis and the acute coronary syndromes have turned out to be thromboinflammatory diseases. Recent data suggest that inflammation also plays an important role in the pathogenesis and outcome of cardiogenic shock. This review will summarize recent advances in the understanding of the pathophysiology of cardiogenic shock related to the inflammatory network and will discuss recent findings in the treatment of patients with cardiogenic shock in relation to these new insights. ⋯ The promising results of studies that tested a potential benefit of drugs with clear or potential antiinflammatory/immunomodulatory properties in patients with cardiogenic shock underscores the importance of the inflammatory network in the pathogenesis and outcome of this devastating complication of cardiovascular disease.
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Severe sepsis and septic shock are common and deadly conditions for which the epidemiology, pathogenesis, and management continue to evolve. Recent publications (2003 and early 2004) have been systematically reviewed for important new original research and scholarly reviews, with an emphasis on clinical advances in adults. ⋯ The works reviewed reflect the advances in the care of patients with sepsis.