Formal Academic Training on Ethics May Address Junior Physicians' Needs.

Background: Surveys have highlighted perceived deficiencies among ICU residents in end-of-life care, symptom control, and confidence in dealing with dying patients. Lack of formal training may contribute to the failure to meet the needs of dying patients and their families. The objective of this study was to evaluate junior intensivists' perceptions of triage and of the quality of the dying process before and after formal academic training.

The prognostic value of ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13) deficiency in septic shock patients involves interleukin-6 and is not dependent on disseminated intravascular coagulation.

Introduction: ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13) deficiency has been reported in patients with sepsis but its clinical relevance and pathophysiology remain unclear. Our objectives were to assess the clinical significance, prognostic value and pathophysiology of ADAMTS13 deficiency in patients with septic shock with and without disseminated intravascular coagulation (DIC).

Methods: This was a prospective monocenter cohort study of patients with septic shock.

Determinants of recovery from severe posterior reversible encephalopathy syndrome.

Objective: Few outcome data are available about posterior reversible encephalopathy syndrome (PRES). We studied 90-day functional outcomes and their determinants in patients with severe PRES.

Design: 70 patients with severe PRES admitted to 24 ICUs in 2001-2010 were included in a retrospective cohort study.

Impact of an intensive care unit diary on psychological distress in patients and relatives*.

Objective: To assess the impact of an intensive care unit diary on the psychological well-being of patients and relatives 3 and 12 months after intensive care unit discharge.

Design: Prospective single-center study with an intervention period between two control periods.

Setting: Medical-surgical intensive care unit in a 460-bed tertiary hospital.

Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients.

Background: Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT) in critically ill immunocompromised patients.

Methods: This prospective, observational study included patients with suspected sepsis.

Survival trends in critically ill HIV-infected patients in the highly active antiretroviral therapy era.

Introduction: The widespread use of highly active antiretroviral therapy (ART) has reduced HIV-related life-threatening infectious complications. Our objective was to assess whether highly active ART was associated with improved survival in critically ill HIV-infected patients.

Methods: A retrospective study from 1996 to 2005 was performed in a medical intensive care unit (ICU) in a university hospital specialized in the management of immunocompromised patients.

Opinions of families, staff, and patients about family participation in care in intensive care units.

Purpose: The aims of the study were to assess opinions of caregivers, families, and patients about involvement of families in the care of intensive care unit (ICU) patients; to evaluate the prevalence of symptoms of anxiety and depression in family members; and to measure family satisfaction with care.

Materials And Methods: Between days 3 and 5, perceptions by families and ICU staff of family involvement in care were collected prospectively at a single center. Family members completed the Hospital Anxiety and Depression Scale (HADS) and a satisfaction scale (Critical Care Family Needs Inventory).

Etiologies and outcome of acute respiratory failure in HIV-infected patients.

Objective: To assess the etiologies and outcome of acute respiratory failure (ARF) in HIV-infected patients over the first decade of combination antiretroviral therapy (ART) use.

Methods: Retrospective study of all HIV-infected patients (n = 147) admitted to a single intensive care unit (ICU) for ARF between 1996 and 2006.

Results: ARF revealed the diagnosis of HIV infection in 43 (29.

Performance of N-terminal-pro-B-type natriuretic peptide in critically ill patients: a prospective observational cohort study.

Introduction: The purpose of this study was to assess the accuracy of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) as a diagnostic tool to recognize acute respiratory failure of cardiac origin in an unselected cohort of critically ill patients.

Methods: We conducted a prospective observational study of medical ICU patients. NT-proBNP was measured at ICU admission, and diagnosis of cardiac dysfunction relied on the patient's clinical presentation and echocardiography.

Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure.

Objectives: The current trend to manage critically ill hematologic patients admitted with acute respiratory failure is to perform noninvasive ventilation to avoid endotracheal intubation. However, failure of noninvasive ventilation may lead to an increased mortality.

Design: Retrospective study to determine the frequency of noninvasive ventilation failure and identify its determinants.

Influence of ischemia on heart-rate variability in chronic hemodialysis patients.

Background: Sudden cardiac death occurring in patients with end-stage renal disease (ESRD) may be related to poor autonomic function with a significant decreased heart-rate variability (HRV). In addition, coronary artery disease has a high prevalence in this population and accounts for 50% of deaths. In the present study, relationships between HRV and myocardial ischemic abnormalities revealed by myocardial scintigraphy (MS) were evaluated in 32 chronic hemodialysis patients.