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Consent for both medical and virtual autopsies was sought from the families of all consecutive patients who died in the ICU between 1 January and 30 June Clinical records were reviewed to determine whether unsuspected autopsy findings would have altered care if known major diagnosis or would not have altered care minor diagnosis.

Fourteen new major and 88 new minor diagnoses were detected by any autopsy method. The main diagnoses missed by virtual autopsy were cardiovascular events 9 of 72 and cancer 12 of In contrast, medical autopsy missed 13 traumatic fractures and 2 pneumothoraces.

Among additional patients in whom only virtual autopsy was performed, 11 new major diagnoses were made.

This may also hold true, at least in part, for the educational aspect of medical autopsy confirming antemortem clinical diagnoses.

Further studies are required to confirm these preliminary results. Auf Nr. Die Ergebnisse der nachfolgenden klassischen Autopsie waren dem Radiologen nicht bekannt.

Klinische Diagnosen und Todesursachen waren bekannt, nicht jedoch das Ergebnis der virtuellen Autopsie.

Neben den beeindruckenden Darstellungen muss auf die Vor-, aber auch Nr. Auch die Fehllage von Kathetern und anderen Objekten ist sicher nachweisbar.

Auch wenn die Kosten einer virtuellen Autopsie in einer Studie deutlich unter den Kosten einer konventionellen Autopsie lagen Weustink AC; Radiology ; , bleibt dieser wichtige Punkt derzeit unklar.

Dies sicherlich nicht. Uwe Janssens Medizinische Klinik St. Initial trophic vs full enteral feeding in patients with acute lung injury: The EDEN randomized trial.

OBJECTIVE: To determine if initial lower-volume trophic enteral feeding would increase ventilator-free days and decrease gastrointestinal intolerances compared with initial full enteral feeding.

Participants were adults within 48 hours of developing acute lung injury requiring mechanical ventilation whose physicians intended to start enteral nutrition at 44 hospitals in the National Heart, Lung, and Blood Institute ARDS Clinical Trials Network.

After day 6, the care of all patients who were still receiving mechanical ventilation was managed according to the full feeding protocol.

Initial trophic feeding did not increase the number of ventilator-free days There were no differences in infectious complications between the groups.

Despite receiving more prokinetic agents, the full-feeding group experienced more vomiting 2. Mean plasma glucose values and average hourly insulin administration were both higher in the full-feeding group over the first 6 days.

Care Med ; Schon eine geringe enterale Kalorienzufuhr im Sinne einer sog. Wie sind nun die Ergebnisse dieser Studie zu bewerten?

Dies war jedoch de facto nicht der Fall. Der Unterschied in der Energie- bzw. So konnten Alberda et al.

Bei der Zufuhr von ca. Pierre Singer et al. Aus unserer Sicht zeigt die Studie dennoch ein interessantes Ergebnis, welches aber von den Autoren nicht ausreichend diskutiert wird.

Letztlich wird eine potentielle Interferenz zwischen der Omega- und der EDEN-Studie, bei der in der Kontrollgruppe etwa 30 g mehr an Protein verabreicht wurde, von den Autoren nicht diskutiert, kann aber unseres Erachtens nicht ausgeschlossen werden.

Interessenskonflikte: T. PD Dr. Thomas W. Schaut man sich also noch einmal die Grundstruktur eines Mitochondrions an Abb.

Zwar ist der UrNr. Zhang et al. Ob sich die von Zhang et al. Und die therapeutischen Konsequenzen? Braucht der schwerverletzte Patient also doch keine Antibiotika-Prophylaxe bzw.

Oder sind die neuen pathophysiologischen Wege umgekehrt Angriffspunkt innovativer adjunktiver Therapien, die eventuell viel weiter gehen als bei infektions-assoziierten Organversagen?

Interessenskonflikte: Keine Prof. An evidence-based recommendation on bed head elevation for mechanically ventilated patients. This recommendation, however, is not an evidence-based one.

Then a European expert panel developed a recommendation based on the results of the systematic review and considerations beyond the scientific evidence in a three-round electronic Delphi procedure.

They made clear that the position of a ventilated patient in bed depended on many determinants. Therefore, given the scientific uncertainty about the benefits and harms of a semi-upright position, this position could only be recommended as the preferred position with the necessary restrictions.

Drakulovic et al. Thomas Staudinger Abb. Werdan in Crit Care Med. Role of receptor for advanced glycation end products in cardiogenic shock.

The available evidence suggests that soluble forms of receptor for advanced glycation end products circulating in the plasma may neutralize the ligand-mediated damage by acting as a decoy.

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