The present investigation provides no evidence for a survival benefit of continuous vs intermittent RRT in ICU patients with ARF.

C1-inhibitor administration attenuated renal impairment in patients with severe sepsis or septic shock.

This study confirms a good agreement between TISS-28 and NEMS in a large, independent sample. However, as shown by the differences between medical and postoperative/trauma patients, a change in case mix may result in different regression equations. Further, wide limits of agreement indicate that there may be a rather large variability between the two measures at the individual level.

The outcome is reported of patients after external chest wall stabilisation for respiratory insufficiency due to a traumatic flail chest. Since 1990, all patients with a flail chest causing respiratory insufficiency despite peridural analgesia and without further reason for prolonged mechanical ventilation underwent osteosynthesis of the chest wall using the AO-technique with 3.5 mm thick reconstruction plates, and were prospectively followed-up by use of clinical and radiological evaluation. 23 patients underwent external chest wall fixation between 1990 and 1996 and were followed for a mean time of 28 months. 2 patients died after the operation, giving a 30-day-survival rate of 91.3% 21 patients survived and were extubated and transferred to the ward after a mean time interval of 3.9 and 7.8 days, respectively. 95% of the survivors revealed a 100% working capacity at assessment and 86% returned to preoperative sports activities without complaining of chest wall or shoulder girdle pain or dysfunction. External chest wall fixation appears to be an attractive alternative to prolonged intubation and mechanical ventilation for selected patients with flail-chest respiratory insufficiency despite peridural analgesia, providing they do not require prolonged intubation for other reasons.

The Molecular Adsorbent Recirculating System (MARS) represents an attractive artificial liver support system for the treatment of liver insufficiency. However, neither indications for MARS treatment (i.e., after extended liver resection) nor criteria for discontinuation of therapy have been evaluated. Therefore, we analyzed the clinical data of all our surgical patients who received MARS treatment for acute liver failure (n = 7). The aim of the study was to identify prognostic indicators for survival. Four of 174 patients resected for hepatic malignancy at our institution received a total of 13 MARS treatments. Two additional patients were successfully bridged to orthotopic liver transplantation with seven MARS treatments and one patient was MARS supported after liver transplantation of a steatotic graft with three MARS treatments. Five of the seven patients survived and were dismissed an average of 31 days, ranging from 17 to 47 days, after the final MARS treatment. No technical complications or adverse effects were observed during the MARS treatments. Important prognostic factors for hepatic recovery and survival were indocyanin green plasma disappearance rates greater than 5%/min and an increase in clotting factor V levels after each MARS treatment. We conclude that MARS therapy can be an effective treatment of postoperative liver insufficiency in the surgical hepatobiliary unit.

Transfusion-related acute lung injury (TRALI) is a potentially life-threatening, probably under-recognized and under-reported complication of transfusing blood products. Conservative transfusion strategies and preclusion of the implicated blood donors with granulocyte-reactive antibodies from future blood donation may prevent TRALI and potentially save lives.

No abstract

PV determination by peripheral i. v. injection of ICG produced reliable and consistent results when a reactive hyperaemia was produced by a tourniquet prior to injection. Therefore, central venous injection of ICG may not be prerequisite for precise measurements of PV. The expected acute increase in PV after infusion of commonly used plasma expanders after cardiac surgery was not found.