Current opinion in critical care
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Curr Opin Crit Care · Dec 2016
ReviewComputer decision support for acute kidney injury: current and future.
Growing awareness regarding the impact of acute kidney injury (AKI) as a grave consequence of critical illnesses resulted in the expansion of the need for early detection and appropriate management strategies. Clinical decision support systems (CDSS) can generate information to improve the care of AKI patients by providing point-of-care accurate patient-specific information and recommendations. Our objective is to describe the characteristics of CDSS and review the current knowledge regarding the impact of CDSS on patients in the acute care settings, and specifically for AKI. ⋯ The heterogeneity of these studies in their size, design, and conduct has produced controversial findings; hence, this has left the field completely open for further investigations.
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Curr Opin Crit Care · Dec 2016
ReviewResuscitative endovascular balloon occlusion of the aorta: promise, practice, and progress?
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive damage control procedure for life-threatening abdominal or pelvic haemorrhage. The purpose of this review is to summarize the current understanding and experience with REBOA, outline potential future applications of this technology, and highlight priority areas for further research. ⋯ Noncompressible torso haemorrhage is the leading cause of preventable trauma deaths. The majority of these deaths occur soon after injury, often before any opportunity for definitive haemorrhage control. For a meaningful reduction in trauma mortality, novel methods of rapid haemorrhage control are required.
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Curr Opin Crit Care · Oct 2016
ReviewRole of lipoproteins and proprotein convertase subtilisin/kexin type 9 in endotoxin clearance in sepsis.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition is a recent high-impact cardiovascular intervention aimed at reducing low-density lipoprotein (LDL) cholesterol levels. Notably, pathogen lipids are also carried in lipoprotein particles and are cleared by hepatocyte LDL receptors. Therefore, the role of PCSK9 in sepsis is reviewed. ⋯ PCSK9 inhibition may be a useful strategy to increase pathogen lipid clearance in the treatment of patients with sepsis.