Intensive care medicine
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Intensive care medicine · Jan 1991
Case ReportsPersistent left superior vena cava--an unusual location of central venous catheters in children.
The incidence of central venous catheters inadvertently placed in a persistent left superior vena cava (PLSVC) was found to be 1.0% in a pediatric population requiring central venous catheterisation. Two well documented cases are presented and the possible association of PLSVC with other non-cardiovascular malformations is suggested.
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Intensive care medicine · Jan 1991
The haemodynamic effects of intermittent haemofiltration in critically ill patients.
The haemodynamic effects of intermittent high volume venovenous haemofiltration were studied in 13 critically ill patients. The mean negative fluid balance during filtration was 1.21 and the mean duration of treatment 3 h 40 min. The cardiac index fell initially (4.5 +/- 0.2 to 3.8 +/- 0.21/min/m2; p less than 0.05) but then remained stable throughout treatment before returning to baseline at the end of haemofiltration. The mean arterial pressure was unchanged with an increase in the systemic vascular resistance (651 +/- 33 to 765 +/- 65 dyne.s/cm5; p less than 0.05) suggesting that vascular responsiveness is maintained during haemofiltration.
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Intensive care medicine · Jan 1991
Comparative StudyBioimpedance versus thermodilution cardiac output measurement: the Bomed NCCOM3 after coronary bypass surgery.
Values obtained for cardiac output (CO) were compared using thermodilution (TD) with those obtained using bioimpedance (Bi) as measured using the Bomed NCCOM3 (Revision 6) in 28 consecutive patients in the first 24 h after coronary artery bypass surgery (CABS). In 46 paired measurements made in the first 12 h after CABS Bi values for CO were significantly lower than TD values, the limits of agreement between the two methods were also unacceptably large (mean Bi 4.38 (SD 1.40) l/min, mean TD 5.46 (SD 1.19) l/min, limits of agreement -3.05 to +0.89). In 55 paired measurements made after 12 h (all in spontaneously breathing patients) there was no significant difference between the two methods and acceptable limits of agreement, mean Bi 5.69 (SD 1.2) l/min mean TD 5.6 (SD 1.2) l/min, limits of agreement -0.99 to +1.17). The significantly lower BiCO values obtained in the first 12 h after CABS show that BiCO measurement is not consistently reliable in the intensive care setting.
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Intensive care medicine · Jan 1991
Case ReportsContinuous multivariable monitoring in neurological intensive care patients--preliminary reports on four cases.
Evoked potential monitoring is a standard examination method in neurological intensive therapy units. Previously, multimodality observation was only possible in follow-up examinations. First experience with a new bed-side system continuously monitoring 12 neurophysiological and clinical parameters is reported. ⋯ This paper reports on 4 exemplary cases of the 33 patients we have monitored to date, illustrating the principles and main advantages of the system. The system was developed to support the observation of ICU patients as well as to aid therapeutic decisions. It supports the clinical determination of brain death by specifying the deterioration of various neurological systems.