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Báo cáo y học: "Recently published papers: A number of treatment controversies"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Recently published papers: A number of treatment controversies. | Critical Care February 2003 Vol 7 No 1 Williams Commentary Recently published papers A number of treatment controversies Gareth Williams Specialist Registrar in Anaesthetics Leicester Royal Infirmary Leicester UK Correspondence Gareth Williams garethdavidwilliams@tiscali.co.uk Published online 10 January 2003 Critical Care 2003 7 16-18 DOI 10.1186 cc1877 This article is online at http ccforum.com content 7 1 16 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract In the present commentary I review some current therapeutic debates. Is noninvasive ventilation going to become the gold standard for acute hypercapnic respiratory failure and if we have to intubate and ventilate then what is the gold standard for sedation Old therapies are challenged e.g. diuretics may worsen outcome and new ones suggested e.g. some critically ill patients may benefit from regular erythropoietin . In addition we must of course mention steroids and sepsis. Keywords respiratory failure sedation sepsis ventilation Growing evidence to support non-invasive ventilation In a report 1 and accompanying editorial 2 the December issue of Intensive Care Medicine casts further light on the topical issue of noninvasive positive pressure ventilation NIPPV in the critically ill. Dr Elliot s editorial 2 eloquently reviews the evidence for use of NIPPV in ventilatory failure resulting from acute exacerbations of chronic obstructive pulmonary disease COPD . He highlights the substantial body of evidence demonstrating the advantages of NIPPV in this group of patients namely a reduction in the need for endotracheal intubation and associated complications infectious complications in particular a reduction in both intensive care and hospital duration of stay and consequently health care costs and even a significantly improved survival rate in one large study 3 . The majority of studies thus far have targeted patients with mild to moderate acute exacerbations of COPD who do not require .