Fluid Resuscitation with 5% albumin versus Normal Saline in Early Septic Shock: a pilot randomized, controlled trial.

Purpose: Randomized, controlled trials of fluid resuscitation in early septic shock face many logistic challenges. We describe the Fluid Resuscitation with 5% albumin versus Normal Saline in Early Septic Shock (PRECISE) pilot trial study design and report feasibility of patient recruitment.

Materials And Methods: Six Canadian academic centers enrolled adult patients with early suspected septic shock from the emergency department and intensive care unit department.

Endoscopic lung volume reduction effectively treats acute respiratory failure secondary to bullous emphysema.

Emphysema often affects the lungs in a heterogeneous fashion, and collapse or removal of severely hyperinflated portions of lung can improve overall lung function and symptoms. The role of lung volume reduction (LVR) surgery in selected patients is well established, but that of non-surgical LVR is still being defined. In particular, use of endobronchial LVR is still under development.

Fluid resuscitation in the management of early septic shock (FINESS): a randomized controlled feasibility trial.

Background: It is unknown whether fluid resuscitation with colloid or crystalloid in patients with severe sepsis or septic shock is associated with an improvement in clinical outcome. This randomized controlled trial determined the feasibility of conducting a large trial testing resuscitation with pentastarch vs normal saline in early septic shock, powered for a difference in mortality.

Methods: At three Canadian and one New Zealand academic centre, 40 patients with early septic shock defined by at least two systemic inflammatory response syndrome criteria, infectious source, and persistent hypotension after >or= 1 L of crystalloid fluid were recruited.

Mucociliary function deteriorates in the clinical range of inspired air temperature and humidity.

Objective: To test whether a reduction in air temperature within the clinical range [37 degrees C to 30, 100% relative humidity (RH)] altered mucus transport velocity (MTV) and ciliary beat frequency (CBF) in an in vitro ovine tracheal model.

Design: Controlled laboratory study.

Setting: University research laboratory.

Energy balance in the intubated human airway is an indicator of optimal gas conditioning.

Objective: The optimal level of inspired heat and humidity for patients receiving long-term mechanical ventilation is still the subject of debate. Many laboratory studies examining surrogate markers for optimal humidity suggest that inspired gas should be at body temperature and fully saturated. The aim of this study was to determine the inspired gas condition that was thermodynamically neutral to the airway of intubated patients, and also examine the contribution of the endotracheal tube to airway heat and water balance.