Electronic Letters to:
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eLetters: Electronic letters published:
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The evidence for supportive care
- Iain R Crossingham (22 August 2006)
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Iain R Crossingham, SpR, Respiratory Medicine Trafford General Hospital
Send letter to journal:
irc{at}doctors.org.uk Iain R Crossingham
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Dear Editor, I found Russell et al's review of the management of people exposed to lung damaging agents fascinating, particularly some of the biologically plausible potential therapies. Whilst I realise it was not the intention of the article to provide a review of critical care, I would like to question some of their unreferenced recommendations for supportive care. The use of dopamine for renal impairment has not been shown to produce clinical benefit [1]. Measurement of pulmonary artery wedge pressures is, at the very least, controversial [2][3]. I would also suggest that if you are applying positive airways pressure during expiration, you should also do so during inspiration. [1] ANZICS Clinical Trials Group. Low-dose dopamine in patients with early renal dysfunction: a placebo controlled randomised trial. Lancet 2000; 356:2139-3 [2] Harvey S et al. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet 2005; 366:472-7 [3] Harvey S, Singer M. Managing critically ill patients with a pulmonary artery catheter. Brit J Hosp Med 2006; 67:421-6 |
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