Critical care : the official journal of the Critical Care Forum
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The complex biology of critical illness not only reflects the initial insult that brought the patient to the intensive care unit but also, and perhaps even more importantly, it reflects the consequences of the many clinical interventions initiated to support life during a time of lethal organ system insufficiency. The latter may amplify or modify the response to the former and are eminently amenable to modulation by changes in practice. ⋯ In the preceding issue of Critical Care, O'Mahony and colleagues reported on an animal model in which sequential insults--low-dose endotoxin followed by mechanical ventilation--induce much greater remote organ injury than either insult alone. Although animal models are poor surrogates for clinical illness, studies such as these provide valuable platforms for probing the complex interactions between insult and therapy that give rise to the intricate biology of critical illness.
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Review Meta Analysis Comparative Study
Exogenous pulmonary surfactant for the treatment of adult patients with acute respiratory distress syndrome: results of a meta-analysis.
The purpose of this study was to perform a systematic review and meta-analysis of exogenous surfactant administration to assess whether this therapy may be useful in adult patients with acute respiratory distress syndrome. ⋯ Exogenous surfactant may improve oxygenation but has not been shown to improve mortality. Currently, exogenous surfactant cannot be considered an effective adjunctive therapy in acute respiratory distress syndrome.