Peter Lauwers

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OBJECTIVES Maintenance of normoglycemia with insulin reduces mortality and morbidity of critically ill patients. Here we report the factors determining insulin requirements and the impact of insulin dose vs. blood glucose control on the observed outcome benefits. DESIGN A prospective, randomized, controlled trial. SETTING A 56-bed predominantly surgical(More)
OBJECTIVE To evaluate the efficacy of two regimens of selective decontamination of the digestive tract in mechanically ventilated patients. DESIGN Prospective, randomized, concurrent trial. SETTING Multidisciplinary intensive care unit (ICU) in a 1,800-bed university hospital. PATIENTS Consecutive patients (n = 660) who were likely to require(More)
OBJECTIVES Dopamine, a natural catecholamine with hypophysiotropic properties, is used as a first choice drug for inotropic and vasoactive support in pediatric intensive care. In infants and children, the pituitary gland plays a crucial role as a regulator of growth, metabolism, maturation and, possibly, immune function. We evaluated the effect of dopamine(More)
The catabolic state of prolonged critical illness is associated with a low activity of the thyrotropic and the somatotropic axes. The neuroendocrine component in the pathogenesis of these low activity states was assessed by investigating the effects of continuous intravenous infusions of TRH, GH-releasing peptide-2 (GHRP-2), and GHRH. Twenty adult patients,(More)
OBJECTIVE The sick euthyroid syndrome is a poorly understood hallmark of critical illness. Dopamine is a natural catecholamine with hypophysiotrophic properties, that is used as an inotropic agent of first choice in intensive care medicine. We explored the effect of dopamine infusion (5 micrograms/kg/min) on the sick euthyroid syndrome of critically ill(More)
The evolution of the septic state and the mortality rate are analyzed in a group of 42 selected patients presenting with severe peritonitis from small or large intestinal origin. All patients presented in a septic state with signs of generalized peritonitis for at least 24 hours. Planned relaparotomies are preferable to the conventional surgical approach of(More)
Prolonged critical illness is characterized by protein hypercatabolism and preservation of fat depots, associated with blunted GH secretion, elevated serum cortisol levels, and low insulin-like growth factor I (IGF-I) concentrations. In this condition, GH is readily released in response to a bolus of GHRH and GH-releasing peptide-2 (GHRP-2) and,(More)
Acute renal failure in critically ill patients is seldom an isolated problem but is more usually associated with multiple organ failure. When choosing an extracoporeal kidney replacement therapy, these other failing organs must be taken into account. Therefore the choice of an artificial kidney in patients requiring intensive care depends on both the(More)
OBJECTIVE Infusion of GH secretagogues appears to be a novel endocrine approach to reverse the catabolic state of critical illness, through amplification of the endogenously blunted GH secretion associated with a substantial IGF-I rise. Here we report the dynamic characteristics of spontaneous nightly TSH and PRL secretion during prolonged critical illness,(More)