References of "Current Opinion in Critical Care"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailAssessment of consciousness with electrophysiological and neurological imaging techniques.
Bruno, Marie-Aurélie ULg; Gosseries, Olivia ULg; Ledoux, Didier ULg et al

in Current Opinion in Critical Care (2011)

PURPOSE OF REVIEW: Brain MRI (diffusion tensor imaging and spectroscopy) and functional neuroimaging (PET, functional MRI, EEG and evoked potential studies) are changing our understanding of patients with ... [more ▼]

PURPOSE OF REVIEW: Brain MRI (diffusion tensor imaging and spectroscopy) and functional neuroimaging (PET, functional MRI, EEG and evoked potential studies) are changing our understanding of patients with disorders of consciousness encountered after coma such as the 'vegetative' or minimally conscious states. RECENT FINDINGS: Increasing evidence from functional neuroimaging and electrophysiology demonstrates some residual cognitive processing in a subgroup of patients who clinically fail to show any response to commands, leading to the recent proposal of 'unresponsive wakefulness syndrome' as an alternative name for patients previously coined 'vegetative' or 'apallic'. SUMMARY: Consciousness can be viewed as the emergent property of the collective behavior of widespread thalamocortical frontoparietal network connectivity. Data from physiological, pharmacological and pathological alterations of consciousness provide evidence in favor of this hypothesis. Increasing our understanding of the neural correlates of consciousness is helping clinicians to do a better job in terms of diagnosis, prognosis and finally treatment and drug development for these severely brain-damaged patients. The current challenge remains to continue translating this research from the bench to the bedside. Only well controlled large multicentric neuroimaging and electrophysiology studies will enable to identify which paraclinical diagnostic or prognostic test is necessary for our routine evidence-based assessment of individuals with disorders of consciousness. [less ▲]

Detailed reference viewed: 111 (10 ULg)
Full Text
See detailThe ideal arena for intensive and continuous questioning
Preiser, Jean-Charles ULg

in Current Opinion in Critical Care (2006), 12(4), 289-289

Detailed reference viewed: 5 (0 ULg)
Full Text
See detailDiarrhoea in the critically ill
Wiesen, Patricia ULg; Van Gossum, A.; Preiser, Jean-Charles ULg

in Current Opinion in Critical Care (2006), 12(2), 149-154

Purpose of review The purpose of this review is to update the knowledge on diarrhoea, a common problem in critically ill patients. Epidemiological data will be discussed, with special emphasis on ... [more ▼]

Purpose of review The purpose of this review is to update the knowledge on diarrhoea, a common problem in critically ill patients. Epidemiological data will be discussed, with special emphasis on diarrhoea in tube-fed patients and during antibiotic therapy. The possible preventive and therapeutic measures will be presented. Recent findings The need for concise definitions of diarrhoea was recently re-emphasized. The use of pump-driven continuous instead of intermittent enteral feeding is less often associated with diarrhoea. The discontinuation of enteral feeding during diarrhoea is not justified. Clostridium difficile-associated diarrhoea is frequent during antibiotic therapy with quinolones and cephalosporins. Formulas enriched with water-soluble fibres are probably effective to prevent diarrhoea, and promising data on the modulation of gut microflora with probiotics and prebiotics were recently released. Summary Diarrhoea is common in critically ill patients, especially when sepsis and hypoalbuminaemia are present, and during enteral feeding and antibiotic therapy. The management of diarrhoea includes generous hydration, compensation for the loss of electrolytes, antidiarrheal oral medications, the continuation of enteral feeding, and metronidazole or glycopeptides in the case of moderate to severe C. difficile colitis. The place of enteral formulas enriched with water-soluble fibres, probiotics and prebiotics is not yet fully defined. [less ▲]

Detailed reference viewed: 108 (2 ULg)
Full Text
See detailAntioxidant Therapy in Intensive Care
Lovat, R.; Preiser, Jean-Charles ULg

in Current Opinion in Critical Care (2003), 9(4), 266-70

PURPOSE OF REVIEW: This review intends to summarize the recent findings regarding the presence of increased oxidative stress in critically ill patients and its potential pathophysiologic role, as well as ... [more ▼]

PURPOSE OF REVIEW: This review intends to summarize the recent findings regarding the presence of increased oxidative stress in critically ill patients and its potential pathophysiologic role, as well as the results of recent clinical trials of antioxidant therapies. RECENT FINDINGS: Several lines of evidence confirm the increase in oxidative stress during critical illness. The oxidative damage to cells and tissues eventually contributes to organ failure. Prophylactic administration of antioxidant vitamins or glutamine, incorporated in the nutritional support or given as separate medications, efficiently attenuates the oxidative stress and in some studies improves the outcome of critically ill patients. Few data on the effects of N-acetylcysteine or trace elements have been published during the last two years. SUMMARY: Patients at risk of organ failure could benefit from the early adjunction of antioxidant treatment, including vitamins and glutamine. [less ▲]

Detailed reference viewed: 5 (0 ULg)
Full Text
Peer Reviewed
See detailNitric oxide: does it play a role in the heart of the critically ill?
MASSION, Paul ULg; Moniotte, S.; Balligand, J. L.

in Current Opinion in Critical Care (2001), 7(5), 323-36

Nitric oxide regulates many aspects of myocardial function, not only in the normal heart but also in ischemic and nonischemic heart failure, septic cardiomyopathy, cardiac allograft rejection, and ... [more ▼]

Nitric oxide regulates many aspects of myocardial function, not only in the normal heart but also in ischemic and nonischemic heart failure, septic cardiomyopathy, cardiac allograft rejection, and myocarditis. Accumulating evidence implicates the endogenous production of nitric oxide in the regulation of myocardial contractility, distensibility, heart rate, coronary vasodilation, myocardial oxygen consumption, mitochondrial respiration, and apoptosis. The effects of nitric oxide promote left ventricular mechanical efficiency, ie, appropriate matching between cardiac work and myocardial oxygen consumption. Most of these beneficial effects are attributed to the low physiologic concentrations generated by the constitutive endothelial or neuronal nitric oxide synthase. By contrast, inducible nitric oxide synthase generates larger concentrations of nitric oxide over longer periods of time, leading to mostly detrimental effects. In addition, the recently identified beta3-adrenoceptor mediates a negative inotropic effect through coupling to endothelial nitric oxide synthase and is overexpressed in heart failure. An imbalance between beta 1 and beta2-adrenoceptor and beta3-adrenoceptor, with a prevailing influence of beta3-adrenoceptor, may play a causal role in the pathogenesis of cardiac diseases such as terminal heart failure. Likewise, changes in the expression of endothelial nitric oxide synthase or inducible nitric oxide synthase within the myocardium may alter the delicate balance between the effects of nitric oxide produced by either of these isoforms. New treatments such as selective inducible nitric oxide synthase blockade, endothelial nitric oxide synthase promoting therapies, and selective beta3-adrenoceptor modulators may offer promising new therapeutic approaches to optimize the care of critically ill patients according to their stage and specific underlying disease process. [less ▲]

Detailed reference viewed: 11 (1 ULg)