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The activation of poly-ADP-ribose-polymerase enzyme (PARP) plays an important role in the pathophysiology of sepsis [1]. In previous animal models, lipopolysaccharide-induced systemic inflammatory response was significantly reduced by the inhibition of PARP [2]. The aim of our study was to investigate the effect of PARP inhibition on systemic inflammation in a septic animal model.

Central venous saturation ScvO2 proved a useful alternative to mixed venous saturation, and also a reliable parameter to evaluate the oxygen debt in emergency and intensive care [1-3]. Under special circumstances of anatomical or coagulation disorders, however, canulation of the jugular or subclavian veins are not recommended. In these cases the femoral vein has to be catheterised. The aim of our prospective study was to investigate the relationship between the ScvO2 measured in the superior vena cava (ScvsO2) and in the inferior vena cava (ScviO2).

Although requirements of human resources in the ICU are well defined (six nurses per bed in level III and four nurses per bed in level II ICUs), these guidelines are not followed in many countries and evidence is also lacking [1]. The aim of this study was to investigate the effect of the number of nurses on the survival in multiple system organ failure (MSOF) on an eight-bed level-III ICU.

The aim of this study was to investigate the short-term effect of fluid resuscitation with 4% modified fluid gelatine (GEL) versus 6% hydroxyethyl starch (HES) on haemodynamics and oxygenation in patients with septic shock and acute lung injury (ALI).Prospective randomised clinical trial.Twenty-bed intensive care unit in a university hospital.Thirty hypovolemic patients (intrathoracic blood volume index, ITBVI850 ml/m(2)) in septic shock with ALI were randomised into HES (mean molecular weight: 200,000 Dalton, degree of substitution 0.6) and GEL (mean molecular weight: 30,000 Dalton) groups (15 patients each).For fluid resuscitation 250 ml/15 min boluses (max. 1,000 ml) were given until the end point of ITBVI900 ml/m(2) was reached. Repeated haemodynamic measurements were done at baseline (t(b)), at the end point (t(ep)) then at 30 min and 60 min after the end point was reached (t(30), t(60)). Cardiac output, stroke volume, extravascular lung water (EVLW), and oxygen delivery was determined at each assessment point. For statistical analysis two-way ANOVA was used.ITBVI, cardiac index, and oxygen delivery index increased significantly at t(ep) and remained elevated for t(30) and t(60), but there was no significant difference between the two groups. The increase in the ITBVI by 100 ml of infusion was similar in both groups (HES: 26+/-19 ml/m(2) vs GEL: 30+/-19 ml/m(2)). EVLW, remained unchanged, and there was no significant difference between the groups (HES, t(b): 8+/-6, t(60): 8+/-6; GEL, t(b): 8+/-3, t(60): 8+/-3 ml/kg). The PaO(2)/FiO(2) did not change significantly over time or between groups (HES, t(b): 207+/-114, t(60): 189+/-78; GEL, t(b): 182+/-85, t(60): 182+/-85 mmHg).The results of this study indicate that both HES and GEL infusions caused similar short-term change in ITBVI in septic shock, without increasing EVLW or worsening oxygenation.