Inhaled colistin may achieve high drug concentrations in the lung. However, a dose of 80 mg of inhaled CMS every 8 h may not be adequate for the treatment of lower respiratory tract infections due to multi-drug resistant GNB.

Background: Although mixed venous O₂ saturation (SvO₂) accurately indicates the balance of O₂ supply/demand and provides an index of tissue oxygenation, the use of a pulmonary artery (PA) catheter is associated with significant costs, risks and complications. Central venous O₂ saturation (ScvO₂), obtained in a less risky and costly manner, can be an attractive alternative to SvO₂. Objectives: To investigate whether the values of ScvO₂ and SvO₂ are well correlated and interchangeable in the evaluation of critically ill ICU patients and to create an equation that could estimate SvO₂ from ScvO₂. Methods: Sixty-one mechanically ventilated patients were catheterized upon admission and ScvO₂ and SvO₂ values were simultaneously measured in the lower part of the superior vena cava and PA respectively. Results: SvO₂ was 68.6 ± 1.2% (mean ± SEM) and ScvO₂ was 69.4 ± 1.1%. The difference is statistically significant (p < 0.03). The correlation coefficient r is 0.945 for the total population, 0.937 and 0.950 in surgical and medical patients, respectively. In 90.2% of patients the difference was <5%. When regression analysis was performed, among 11 models tested, power model [SvO₂ = b0(ScvO₂)^b1] best described the relationship between the two parameters (R² = 0.917). Conclusions: ScvO₂ and SvO₂ are closely related and are interchangeable for the initial evaluation of critically ill patients even if cardiac indices are different. SvO₂ can be estimated with great accuracy by ScvO₂ in 92% of the patients using a power model.

In spite of substantial extracorporeal clearance, total colistin clearance was reduced, compared with patients with normal renal function. Colistin adsorption by the haemofilter contributed to its extracorporeal clearance to a large extent. Studies on other patients receiving colistin methane sulphonate and undergoing CRRT are required before more appropriate dosage regimens can be recommended.

No abstract

AIm: Our research was focused on the neuroprotective function of erythropoietin (Epo) in patients with severe closed traumatic brain injury (TBI). mATeRIAL and meTHods: Our model examined the influence of the outcome and neurological recovery in 42 adults with TBI who were admitted to ICU within 6 hours of their injury and were recruited into a randomized controlled study of two groups; only the patients of the intervention group received 10,000 i.u. of Epo for 7 consecutive days. A prognostic model based on CRASH II injury model and outcome was measured by survival and Glasgow Outcome Scale-Extended version (GOS-E) score at 6 months post-injury.ResuLTs: Six patients (18.7%) died during the first two weeks; 4 of the control group and 2 of the intervention group. A mortality rate of 22.2% and 8.3% for the control and intervention group respectively was observed. A lower rate of good outcome (GOS-E score > 4) at 6 months was mentioned among patients of the control group. CoNCLusIoN:The study provides evidence of lower mortality and better neurological outcome for the patients who received Epo increasing the possibility that Epo therapy could be used in clinical practice, limiting neuronal damage induced by TBI.KeywoRds: Brain, Injury, Erythropoietin, Mortality, Outcome ÖZ AmAÇ: Araştırmamız, şiddetli kapalı travmatik beyin yaralanması (TBY) olan hastalarda eritropoietinin (Epo) nöroprotektif işlevi üzerine odaklanmıştı. yÖNTem ve GeReÇLeR: Modelimiz, yaralanmadan sonra 6 saat içinde yoğun bakıma gelen ve iki grup halinde randomize kontrollü bir çalışmaya kaydedilen 42 yetişkinde sonuç ve nörolojik iyileşme üzerine etkiyi inceledi; sadece girişim grubundaki hastalara arka arkaya 7 gün boyunca 10.000 i.u. Epo uygulandı. Yaralanmadan 6 ay sonra CRASH II yaralanma modeli temelinde prognostik bir model kullanıldı ve sonuç sağkalım ve Glasgow Sonuç Ölçeği-Genişletilmiş versiyon (GOS-E) puanıyla ölçüldü.BuLGuLAR: İlk iki haftada kontrol grubunda 4 ve girişim grubunda 2 hasta olarak altı hasta (%18,7) öldü. Kontrol ve girişim grupları için sırasıyla %22,2 ve %8,3 mortalite oranı gözlendi. Kontrol grubunda 6 ayda daha düşük bir iyi sonuç oranı (GOS-E puanı > 4) görüldü.soNuÇ: Çalışma, Epo alan hastalarda daha düşük mortalite ve daha iyi nörolojik sonuç bulguları vermiştir ve böylece Epo tedavisinin klinik uygulamada kullanılıp TBY nedeniyle oluşan nörolojik hasarı sınırlaması olasılığını ortaya koymuştur.