Guidelines for Complications of Cancer Treatment Vol VIII Part B

had similar baseline characteristics. There were 726 deaths inthe albumin group, as compared with 729 deaths in the salinegroup (relative risk of death, 0.99; 95 percent confidenceinterval, 0.91 to 1.09; P=0.87). The proportion of patients withnew single-organ and multiple-organ failure was similar inthe two groups (P=0.85). There were no significant differencesbetween the groups in the mean (+/-SD) numbers of days spentin the ICU (6.5+/-6.6 in the albumin group and 6.2+/-6.2 inthe saline group, P=0.44), days spent in the hospital (15.3+/-9.6 and 15.6+/-9.6, respectively; P=0.30), days of mechanicalventilation (4.5+/-6.1 and 4.3+/-5.7, respectively; P=0.74), ordays of renal-replacement therapy (0.5+/-2.3 and 0.4+/-2.0,respectively; P=0.41). CONCLUSIONS: In patients in theICU, use of either 4 percent albumin or normal saline for fluidresuscitation results in similar outcomes at 28 days.PMID: 15163774 [PubMed - indexed for MEDLINE]LeDoux D, Astiz ME, Carpati CM, et al. Effects ofperfusion pressure on tissue perfusion in septic shock.Rackow EC. Crit Care Med. 2000; 28: 2729-32OBJECTIVE: To measure the effects of increasing meanarterial pressure (MAP) on systemic oxygen metabolism andregional tissue perfusion in septic shock. DESIGN: Prospectivestudy. SETTING: Medical and surgical intensive care units ofa tertiary care teaching hospital. PATIENTS: Ten patients withthe diagnosis of septic shock who required pressor agents tomaintain a MAP > or = 60 mm Hg after fluid resuscitation toa pulmonary artery occlusion pressure (PAOP) > or = 12 mmHg. INTERVENTIONS: Norepinephrine was titrated to MAPsof 65, 75, and 85 mm Hg in 10 patients with septic shock.MEASUREMENTS AND MAIN RESULTS: At each levelof MAP, hemodynamic parameters (heart rate, PAOP, cardiacindex, left ventricular stroke work index, and systemic vascularresistance index), metabolic parameters (oxygen delivery,oxygen consumption, arterial lactate), and regional perfusion92