Abstract
Withdrawal of artificial nutrition and hydration (ANH) is ethically justified for patients with irreversible disorders of consciousness (coma, vegetative (VS), minimally conscious state (MCS)) [1]. However, the absence of definite ethical steps within the medical community makes objective end-of-life decisions difficult to take. The present survey aims to debrief attitudes towards end-of-life decisions in these patients in order to facilitate future guidelines.
Highlights
We previously showed that erythropoietin (EPO) attenuates the morphological signs of spinal cord ischemia/reperfusion (I/R) injury in swine [1] without, improving neurological function
The clinical use of EPO has been cautioned most recently due to serious safety concerns arising from an increased mortality in acute stroke patients treated with EPO and simultaneously receiving systemic thrombolysis [2]
In awake, spontaneously breathing mice, inhaling hydrogen sulfide (H2S) induced a hibernation-like metabolic state characterised by reduced energy expenditure and hypothermia [1], which protected against otherwise lethal hypoxia [2] and hemorrhage [3]
Summary
We previously showed that erythropoietin (EPO) attenuates the morphological signs of spinal cord ischemia/reperfusion (I/R) injury in swine [1] without, improving neurological function. Methods We studied 90 patients affected by severe sepsis or septic shock previously enrolled in a prospective trial regarding the impact of glycemic control on inflammation and coagulation. In a retrospective analysis of the data from the SBITS-trial [1] we investigated whether the initial level of serum IgG on admission to the hospital in patients with sepsis and septic shock (before the first administration of the first dose of intravenous immunoglobulins) could be seen as a prognostic parameter for the primary outcome, lethality on day 28, or the secondary endpoints, lethality on day 7 or on the ICU. The aim of this analysis was to assess the impact of real-time continuous glucose monitoring (CGM) on glucose variability in critically ill patients receiving intensive insulin therapy (IIT) Methods This is the post hoc analysis of a prospective, randomized, controlled trial [2]. Respecting anonymity we have statistically evaluated 103 replies (response rate was 13.8%) and compared with data from other European countries
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