Critical care : the official journal of the Critical Care Forum
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The time course of plasma albumin concentration (P-alb) and cumulative perioperative albumin shift as a measure of albumin extravasation in major abdominal surgery is not well described. Knowledge of these indices of the vascular barrier and vascular content are important for our understanding of fluid physiology during surgery and anesthesia. ⋯ The rapid fall in P-alb of more than 40 % consistently occurred during the first part of the surgical procedure, but albumin leakage progressed until 1 h after the end of surgery. After the initial drop, P-alb was stable for 72 h.
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The recent Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) challenges current data on the prevalence of acute respiratory distress syndrome (ARDS). The LUNG SAFE investigators claimed that their data demonstrated the predictive validity of the Berlin criteria. Also, the LUNG SAFE showed a disturbingly large gap between scientific evidence and medical practice. All of these statements demand that we question the interpretations of the study's findings.