Terlipressin in the treatment of late phase catecholamine-resistant septic shock.

Background/aims: Norepinephrine, but also dopamine and epinephrine are recommended as first line vasopressors in the treatment of septic shock. In some patients, septic shock deteriorates and becomes to be resistant to catecholamines. In this situation, addition of vasopressin or terlipressin can be advantageous.

Our experience with transoral incisionless plication of gastroesophageal reflux disease: NOTES procedure.

Background/aims: Natural Orifice Transluminal Surgery (NOTES) has been introduced in endoscopic surgery as a new system offering the advantage of a less invasive procedure. Gastroesophageal reflux disease (GERD) appears to be the most promising application of NOTES treatment. The aims of our study were to evaluate the safety and efficacy of this procedure and length of hospital stay.

Therapeutic influence of 20 % albumin versus 6% hydroxyethylstarch on extravascular lung water in septic patients: a randomized controlled trial.

Background/aims: Recent studies demonstrated that extravascular lung water (EVLW) is a reliable and independent marker for outcome. The primary therapeutically goal in critically ill patients is to resuscitate and retain adequate organ perfusion by fluid administration, where is necessary to achieve adequate intravascular filling, but avoid initiation of pulmonary edema.

Methodology: Patients with severe sepsis were randomly allocated to a group treated with 20% Albumin 100 ml every 12 hours (ALB; n = 30) or with 6% hydroxyethylstarch 130/0, 4 250 ml every 6 hours (HES; n = 26).

Brain natriuretic peptide in decompensation of liver cirrhosis in non-cardiac patients.

Background/aims: Brain natriuretic peptide is recently widely used as a diagnostic and prognostic marker of heart failure. Plasma levels of this peptide are elevated in other, non-cardiac conditions as well, among others in liver cirrhosis, especially presenting with fluid retention and,--ascites.

Methods: Circulating levels of BNP was determined in 25 non-cardiac patients, 20 men, 5 women admitted at our medicine department from March 2006 to September 2007 with decompensate ascitic liver cirrhosis.

Can procalcitonin help us in timing of re-intervention in septic patients after multiple trauma or major surgery?

Background/aims: In surgical sepsis, the rapid identification of source of infection at an early stage after surgery or serious trauma is crucial for favorable outcome. The discrimination between local and generalized infection is critical for correct treatment.

Methodology: In a randomized, controlled, single-centre study we investigated 72 patients with severe sepsis after major abdominal surgery or surgery for multiple trauma.