Intensive care medicine
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Intensive care medicine · Jan 1992
Evaluation of indexes predicting the outcome of ventilator weaning and value of adding supplemental inspiratory load.
To assess the diagnostic accuracy of several measured and calculated indexes for early prediction of weaning outcome, and to study the value of supplemental inspiratory load in improving the accurate prediction of successful weaning. ⋯ a) P01/MIP, IEQ and F/Vt ratio were accurate, early predictors of weaning outcome. b) The addition of a moderate mechanical inspiratory load did not enhance the diagnostic accuracy of P01 measurements. c) In our patients, a period of two hours seemed to be sufficient for development and detection of weaning failure.
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Intensive care medicine · Jan 1992
Review Case ReportsRare procedures during delivery room resuscitation--cardioversion of ventricular tachycardia in an asphyctic neonate.
Successful cardioversion of ventricular tachycardia in a full-term male infant, born severely depressed by emergency Cesarean section 9 min after the mother was given bilateral paracervical bupivacaine blocks for pain relief during normal labor, is described. The apparently stillborn baby was resuscitated by conventional means until electronic heart monitoring revealed transition from asystole to rapid ventricular tachycardia 14 min after birth. ⋯ The child recovered rapidly and neurological status at 12 months was normal. Obviously, active search and aggressive management of rapid ventricular arrhythmias are indicated during neonatal resuscitation, if potentially arrhythmogenic drugs are used in perinatal care.
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Intensive care medicine · Jan 1992
Tidal volume, breathing frequency, and oxygen consumption at different pressure support levels in the early stage of weaning in patients without chronic obstructive pulmonary disease.
The objective of this study was to evaluate the influence of different PSV levels on VT, F, VO2 in the early weaning phase of patients without chronic obstructive pulmonary disease. These parameters were tested for the predictive power for the success of the weaning. Patients on SIMV were studied during the first weaning attempt with PSV. ⋯ Responders and nonresponders could be separated by the response of VO2, VT and F to a change in PS 10 to PS 20 cmH2O. Patients who significantly increased VT and significantly decreased F did not fulfil our weaning criteria. Our responders did not show a significant change in these two parameters, but a significant increase in VO2 at PS 20 cmH2O could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Intensive care medicine · Jan 1992
Randomized Controlled Trial Clinical Trial Retracted PublicationPhosphodiesterase-inhibitors enoximone and piroximone in cardiac surgery: influence on platelet count and function.
Some phosphodiesterase (PDE)-inhibitors are believed to alter platelet count and function due to changes in intracellular cAMP. Whether newly developed (specific) PDE-inhibitors negatively influence platelet function in cardiac surgery should be investigated in a randomized study. ⋯ It is concluded that enoximone and the new PDE-III-inhibitor piroximone do not affect platelet function and can be used before CPB without risking platelet-related bleeding in cardiosurgical patients in the perioperative period.