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Nephrology Dialysis Transplantation 2009 24(2):391-395; doi:10.1093/ndt/gfn740
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Kidney diseases beyond nephrology: intensive care

Zaccaria Ricci1 and Claudio Ronco2

1 Department of Paediatric Cardiosurgery, Bambino Gesù Hospital, Rome, Italy 2 Department of Nephrology, Dialysis and Transplantation, S.Bortolo Hospital, Vicenza, Italy

Correspondence and offprint requests to: Zaccaria Ricci, Piazza S. Onofrio 400100, Rome, Italy. Tel: +39-064456115; Fax: +39-0444993949; E-mail: z.ricci@libero.it

Keywords: Tight glycemic control; pulmonary artery catheter; renal replacement dose; fluid balance; extracorporeal membrane oxygenation

The first 150 words of the full text of this article appear below.



   Evidence-based and good sense-based critical care medicine
 
Critical care medicine has improved greatly, thanks to the implementation of guidelines and good clinical practice protocols. For this reason, the present clinical practice requires evidence-based medicine to answer unresolved debates and to further improve applied protocols. Randomized controlled trials are (even if not always [1]) essential in order to achieve a high level of scientific evidence good enough to support the application of new life-saving strategies or to change significantly current practice [2]. Such trials are now strongly needed because mortality has improved to such a level that large investments will be required to achieve relatively small improvements in clinical outcomes. Nevertheless, this approach has justified and encouraged changes in therapeutic strategies sometimes contradicted after only a few years. This not only demonstrates how difficult it is to reach a definitive consensus in the world of critical care medicine but it may also induce perplexity . . . [Full Text of this Article]



   Dialysis dose: a nihilistic approach?
 


   The issue of fluid balance
 


   Conclusions
 

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