Septic shock and the use of norepinephrine in an intermediate care unit: Mortality and adverse events.

Background: Septic shock is associated with high mortality. Aged and multimorbid patients are not always eligible for intensive care units. Norepinephrine is an accepted treatment for hypotension in septic shock.

[Hypernatremia - common condition in critical illness associated with high mortality. But the treatment arsenal is inadequate].

Hypernatremia in ICU is common, both as a preexisting condition and acquired during intensive care. Hypernatremia increases mortality and morbidity as an increased length of a stay and increased risk of complications. Current treatment options of manifest hypernatremia are limited, but there are opportunities for prevention that should not be overlooked.

Hypoventilation does not explain the impaired quality of sleep in postpolio patients ventilated noninvasively vs. invasively.

In a previous study, it was found that patients treated with noninvasive ventilation (NIV) reported larger dysfunctions in sleep-related parameters as assessed with the Sickness Impact Profile (SIP) and Health Index questionnaires than those treated with tracheostomy. The aim of the current study was to further evaluate these sleep limitations and relate these limitations to blood gas analyses in the groups to investigate, if the differences could be related to differences in the efficacy of ventilation. We compared postpolio patients treated with tracheostomy (PPT, n = 17), NIV (PPN, n = 14) and patients with neuromuscular disorders treated with NIV (NMN, n = 15).

Synthesis rates of total liver protein and albumin are both increased in patients with an acute inflammatory response.

The general perception that catabolism and inflammation are associated with a high synthesis rate of total liver protein and a low albumin synthesis rate has been challenged in recent years by several studies in man, indicating that the synthesis rate of albumin in response to a catabolic insult is increased rather than decreased. Thus changes in liver protein synthesis rates in conjunction with catabolism and acute inflammation in man need to be characterized better. The aim of the present study was to measure protein synthesis rates of total liver protein and albumin during a state of acute inflammation.

The synthesis rate of albumin decreases during laparoscopic surgery.

In previous studies, a decline in total liver protein synthesis during elective laparoscopic surgery has been observed. However, when albumin synthesis was measured in parallel no apparent influence of the procedure was detected. The aim of the present study was to specifically investigate the effect of a laparoscopic procedure on albumin synthesis.

Albumin synthesis in humans increases immediately following the administration of endotoxin.

In order to investigate the immediate (i.e. within 3 h) response of albumin synthesis to the administration of endotoxin, as a model of a moderate and well controlled catabolic insult, two measurements employing L-[(2)H(5)]phenylalanine were performed in 16 volunteers.