EVERE SEPSIS AND SEPTIC SHOCK AREcommon problems in the intensive care unit (ICU) and carry a high mortality. Endotoxin, one of the principal components on the outer membrane of gram-negative bacteria, is considered relevant to their pathogenesis. High levels of endotoxin activity are associated with worse clinical outcomes. 1 However, effectiveness of endotoxintargeted therapy is still controversial. 2,3 Polymyxin B, an antibiotic with high affinity for endotoxin, has been bound and immobilized to polystyrene fibers in a medical device for hemoperfusion. This device can effectively bind endotoxin both in vitro and in vivo and could potentially interrupt the biological cascade of sepsis. 4 In a systematic review, 5 direct hemoperfusion with the See also p 2496 and Patient Page.

Application of recruiting maneuvers improves oxygenation only in patients with early ARDS who do not have impairment of chest wall mechanics and with a large potential for recruitment, as indicated by low values of EstL.

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Nendel 38 | Jørgen Eivind Olesen 37 | Taru Palosuo 44 | John R. Porter 42,45,46 | Eckart Priesack 39 | Dominique Ripoche 47 | Mikhail A. Semenov 48 | Claudio Stöckle 17 | Pierre Stratonovitch 48 | Thilo Streck 33 | Iwan Supit 49 | Fulu Tao 50,44 | Marijn Van der Velde 51 | Daniel Wallach 52 | Enli Wang 53 | Heidi Webber 30,38 AbstractWheat grain protein concentration is an important determinant of wheat quality for human nutrition that is often overlooked in efforts to improve crop production. We tested and applied a 32-multi-model ensemble to simulate global wheat yield and quality in a changing climate. Potential benefits of elevated atmospheric CO 2 concentration by 2050 on global wheat grain and protein yield are likely to be negated by impacts from rising temperature and changes in rainfall, but with considerable 156 |

This first randomized controlled multicenter trial on the use of xenon as an inhalational anesthetic confirms, in a large group of patients, that xenon in oxygen provides effective and safe anesthesia, with the advantage of a more rapid recovery when compared with anesthesia using isoflurane-nitrous oxide.