BIOÉTICA
ICU Care at the End of Life
Total health-care costs in the United States have reached an astonishing $1.4 trillion, or 14% of the gross domestic product. Per capita spending is double that of other industrialized nations.1 Yet, according to the World Health Organization...

ENDOCRINOLOGÍA
The Evolving Paradigm of Hyperglycemia and Critical Illness
It is fascinating to observe how the approach to the diagnosis and treatment of a particular medical condition evolves over time. The treatment of hyperglycemia in the setting of critical illness represents one such example...

FARMACOLOGÍA
Heparin and Low-Molecular-Weight Heparin The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy
Heparin, a heterogeneous mixture of branched glycosaminoglycans, was discovered to have antithrombotic properties by McLean almost 90 years ago. 1 Brinkhous and associates 2 then demonstrated that heparin is an indirect anticoagulant, requiring a plasma cofactor...

NEUROLOGÍA
Severe trauma and subsequent extensive tissue damage cause a trauma-related excess of oxidative stress and cellular injury.
Severe trauma and subsequent extensive tissue damage cause a trauma-related excess of oxidative stress and cellular injury. Moreover, the catabolic state induced by stress is associated with the retention of sodium and water and the concomitant expansion of the extracellular fluid compartment...

VENTILACIÓN MECÁNICA
Detrimental Effects of Mechanical Ventilation with Low Tidal Volumes in Patients without Acute Lung Injury (ALI) or Acute Respiratory Distress Syndrome (ARDS)
Recent data has shown that the use of reduced tidal volumes during mechanical ventilation of patients with ALI or ARDS can improve outcome, possibly by avoiding overinflation of stiff lungs...