Critical care : the official journal of the Critical Care Forum
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Although numerous studies over the past 40 years have addressed this problem, initial graft failure is still a key question in clinical lung transplantation. As a possible tool to avoid and treat initial graft failure after lung transplantation, laboratory evidence and clinical reports currently emphasize the role of substitution therapy of surfactant combined with inhaled nitric oxide.
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The clinical syndrome of sepsis is common, increasing in incidence and responsible for as many deaths annually as ischaemic heart disease. Two recent interventional trials have demonstrated that early recognition and intervention can result in dramatic reductions in acute (28-day) mortality. ⋯ Overcoming this should facilitate wider recognition, not only among health care providers (in particular those working in acute specialties outside intensive care units [ICUs]) but also politicians and the general public. Such education is vital if early recognition and intervention are to be successfully implemented.
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This pro/con debate explores the ethical issues surrounding nonheart-beating organ donation (NHBD), a source of considerable controversy. It is estimated that NHBD can increase the number of organs available for transplant by 25% at a time of great need. ⋯ Against NHBD, there are questions regarding the ambiguity and cultural perspectives of death, regarding whether a separation of rationale between withdrawal and donation is sufficient to preclude conflicts of interest, and regarding whether variable protocols arise that subordinate the patient to the goal of donation. Such concerns suggest NHBD may damage the trust in patient-physician relationships and may adversely affect organ donation rates.