The role of renal function in outcome-prediction models.

General clinical scoring systems are relatively recently developed statistical tools available to clinicians for purposes including comparison of outcome data, evaluation of new therapies, quality assurance, and evaluation of resource utilization. As statistical devices, they are valid when applied to patient groups, not individual prognostication. The most well known general systems are the APACHE (Acute Physiology and Chronic Health Evaluation), SAPS (Simplified Acute Physiology System), and MPM (Mortality Prediction Model).

Acute dialytic support of the octogenarian: is it worth it?

Dialytic support of the elderly has recently come under scrutiny. The consumption of resources and the lack of clear data on outcome have fueled the controversy. In an effort to establish a baseline, we reviewed our experience over the past 5 years of ICU dialysis therapies delivered to patients over 80 years old.

Unilateral auto-PEEP in the recipient of a single lung transplant.

We report a patient who received a right single lung transplant (SLT) for progressive lymphangioleiomyomatosis and required reintubation for postoperative respiratory distress. She developed hemodynamic instability due to mediastinal shift from unilateral auto-PEEP with hyperinflation of the native lung. Placement of a double lumen endotracheal tube (DLET) and institution of differential lung ventilation restored equal lung inflation and hemodynamic stability.

Lung and heart-lung transplantation: the state of the art.

Lung and heart-lung transplantation is one of the most rapidly evolving transplantation fields. Survival has been improving with better patient selection, better graft preservation, and better immunosuppression. This paper outlines criteria for patient selection, reviews the surgical options involving lung transplantation, and discusses factors influencing morbidity and survival in these patients.