Short-term effects of noisy pressure support ventilation in patients with acute hypoxemic respiratory failure.

Introduction: This study aims at comparing the very short-term effects of conventional and noisy (variable) pressure support ventilation (PSV) in mechanically ventilated patients with acute hypoxemic respiratory failure.

Methods: Thirteen mechanically ventilated patients with acute hypoxemic respiratory failure were enrolled in this monocentric, randomized crossover study. Patients were mechanically ventilated with conventional and noisy PSV, for one hour each, in random sequence.

Variability of structures in German intensive care units--a representative, nationwide analysis.

Background: Structures in intensive care medicine comprise human as well as material resources, organization, and management and may be related to processes thereby affecting patients' outcomes. Utilizing a unique data base we evaluated structures of German intensive care units (ICUs).

Methods: The study was carried out by the German Competence Network Sepsis (SepNet).

Practice and perception--a nationwide survey of therapy habits in sepsis.

Objective: To simultaneously determine perceived vs. practiced adherence to recommended interventions for the treatment of severe sepsis or septic shock.

Design: One-day cross-sectional survey.

[Microcirculation in sepsis and septic shock - therapeutic options?].

In severe sepsis and septic shock the severe impairment of the microcirculation is one of the main reasons for tissue hypoxia, multiple organ failure and death. Fast resuscitation of the microvascular blood flow to improve the reduced functional capillary density is necessary. Based scientific evidence, an early haemodynamic stabilisation directed by predefined haemodynamic and metabolic goals and the application of activated protein C (rhAPC) according to the guidelines could be recommended.

Intensive insulin therapy and pentastarch resuscitation in severe sepsis.

Background: The role of intensive insulin therapy in patients with severe sepsis is uncertain. Fluid resuscitation improves survival among patients with septic shock, but evidence is lacking to support the choice of either crystalloids or colloids.

Methods: In a multicenter, two-by-two factorial trial, we randomly assigned patients with severe sepsis to receive either intensive insulin therapy to maintain euglycemia or conventional insulin therapy and either 10% pentastarch, a low-molecular-weight hydroxyethyl starch (HES 200/0.

Epidemiology of sepsis in Germany: results from a national prospective multicenter study.

Objective: To determine the prevalence and mortality of ICU patients with severe sepsis in Germany, with consideration of hospital size.

Design: Prospective, observational, cross-sectional 1-day point-prevalence study.

Setting: 454 ICUs from a representative nationwide sample of 310 hospitals stratified by size.