Prone positioning in severe acute respiratory distress syndrome.

Background: Previous trials involving patients with the acute respiratory distress syndrome (ARDS) have failed to show a beneficial effect of prone positioning during mechanical ventilatory support on outcomes. We evaluated the effect of early application of prone positioning on outcomes in patients with severe ARDS.

Methods: In this multicenter, prospective, randomized, controlled trial, we randomly assigned 466 patients with severe ARDS to undergo prone-positioning sessions of at least 16 hours or to be left in the supine position.

Accuracy of bedside glucometry in critically ill patients: influence of clinical characteristics and perfusion index.

Objectives: To determine the accuracy of bedside glucose strip assay on capillary blood and on whole blood and to identify factors predictive of discrepancies with the laboratory method.

Patients And Methods: We conducted a prospective 3-month (July 1-September 30, 2003) study in 85 consecutive patients who required blood glucose monitoring. Values obtained with a glucose test strip on capillary blood and on whole blood were compared with those obtained in the laboratory during serial blood sampling (up to 4 samples per patient).

[Standard perioperative management of patients treated with lithium can lead to hyperosmolar coma].

A 55-year-old woman with bipolar disorder who had been taking lithium for several years developed hyperosmolar coma following osteosynthesis of a hip fracture. The coma was attributed to decompensation of undiagnosed nephrogenic diabetes insipidus due to chronic lithium intake. The lengthy perioperative fasting and large fluid loading (necessitated by the anesthetic technique) led to acute hypernatremia.

[Prospective assessment of information programme for blood transfusion in critical care patients].

Objectives: Assessment of oral and written information programme for blood transfusion in critical care patients and study of factors associated with the biological follow-up.

Study Design: Prospective study in one intensive care unit.

Patients And Methods: All blood recipients in 2000 were orally informed of transfusion process.