tailieunhanh - Báo cáo khoa học: "Recently published papers: Asking the unanswerable – measuring the immeasurable and decontaminating the infected"

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 ngành y học đề tài: Recently published papers: Asking the unanswerable – measuring the immeasurable and decontaminating the infected. | Critical Care December 2003 Vol 7 No 6 Benepal and Forni Commentary Recently published papers Asking the unanswerable -measuring the immeasurable and decontaminating the infected Hardeep S Benepal1 and Lui G Forni2 1 Renal and Critical Care Registrar Department of Critical Care Medicine Worthing General Hospital Worthing West Sussex UK 2Consultant Intensivist Department of Critical Care Medicine Worthing General Hospital Worthing West Sussex UK Correspondence Lui G Forni Published online 6 November 2003 Critical Care 2003 7 402-404 DOI cc2402 This article is online at http content 7 6 402 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X The greater our knowledge increases the greater our ignorance unfolds. JF Kennedy Address at Vanderbilt University Nashville Tennessee May 18 1963 As 2003 marches on one is left reflecting on yet another year in which the intensive care literature has continued to challenge the accepted tenets and as always one continues to be surprised by the results. The study conducted by Finney and coworkers 1 illustrates well how our increasing knowledge leads to more questions. Since the study by van den Berghe and coworkers 2 was reported much attention has been given to rigorous control of blood glucose levels in patients although as Finney and coworkers 1 pointed out the mechanisms underlying the perceived benefits are unclear. In particular the observed mortality reduction might have been due to avoidance of hyperglycaemia or to the dose of exogenous insulin or perhaps a combination of the two. That observational study of 531 intensive care unit ICU patients 523 studied examined blood glucose levels and quantity of insulin administered a secondary question was to determine whether there was a threshold glucose concentration associated with increased mortality 1 . Glycaemic control was split into six bands that were determined prospectively. The patients were predominantly male .