The implementation of an analgesia-based sedation protocol reduced deep sedation and proved to be safe and feasible in patients on mechanical ventilation.

Introduction: Deep sedation in critically ill patients is associated with a longer duration of mechanical ventilation and a prolonged length of stay in the intensive care unit. Several protocols have been used to improve these outcomes. We implement and evaluate an analgesia-based, goal-directed, nurse-driven sedation protocol used to treat critically ill patients who receive mechanical ventilation.

[Adult pulmonary Langerhans cell histiocytosis. Report of one case].

Adult pulmonary Langerhans cell histiocytosis (PLCH) is a rare disorder of unknown etiology that occurs predominantly in young smokers, with an incidence peak at 20-40 years of age. In adults, pulmonary involvement with Langerhans cell histiocytosis usually occurs as a single-organ disease and is characterized by focal Langerhans cell granulomas infiltrating and destroying distal bronchioles. We report a 23-year-old asymptomatic male smoker with a non specific interstitial infiltrate found in preventive chest X ray examination.

Intra-abdominal hypertension: incidence and association with organ dysfunction during early septic shock.

Purpose: The objective of this article is to study the cumulative incidence of intra-abdominal hypertension (IAH) in septic shock (SS) patients during the first 72 hours of intensive care unit (ICU) admission and to determine if the presence and severity of IAH are associated with sepsis morbidity and mortality.

Materials And Methods: Eighty-one consecutive SS patients admitted to a surgical-medical ICU of an academic university hospital (January 2005 to January 2006) were included. Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) were measured every 6 h (intermittently) for 72 h.

Intraabdominal hypertension in patients with septic shock.

Intraabdominal hypertension (IAH) develops frequently in patients with septic shock. Even a moderate increase in intraabdominal pressure (IAP) in this setting could be associated with high lactate levels. The authors conducted a prospective, observational, nonrandomized control trial in the surgical intensive care unit of an academic tertiary center.