Intensive care medicine
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Intensive care medicine · Jan 1992
Randomized Controlled Trial Clinical TrialPrevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract. A randomized, double blind, placebo-controlled study.
To evaluate the effect of a method of Selective Decontamination of the Digestive Tract (SDD) on colonization, nosocomial infection (NI), bacterial resistance, mortality and economic costs. ⋯ colonization by gram-negative bacilli, NI and the mortality related to it can be modified by SDD. Continuous bacteriological surveillance is necessary.
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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
Case ReportsBronchopulmonary distress associated with toxic epidermal necrolysis.
We describe here a patient with severe TEN and respiratory distress and we review the subject of bronchopulmonary symptoms in TEN. Even if pseudostratified ciliated involvement is uncommon, bronchial lesions in the absence of other known causes, should be specifically related to TEN. The mechanisms of pulmonary involvement and ARDS associated with TEN are discussed.
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Intensive care medicine · Jan 1992
Increase in lung volume originated by extrinsic PEEP in patients with auto-PEEP. The role of static lung compliance.
The use of extrinsic positive end expiratory pressure (PEEPe) in patients with auto-PEEP (AP) can reduce the respiratory work during weaning from mechanical ventilation. However, the application of PEEPe can produce a certain level of hyperinflation, an undesirable effect which can limit the efficacy of the reduction of respiratory work. The objective of the present study has been to determine if the increase in end expiratory lung volume (EELV) originated by the PEEPe is related to static lung compliance (SLC). ⋯ When PEEPe equal to the AP was applied, the EELV increased by 178 +/- 110 ml (range 45-375 ml, p less than 0.05), and there was a significant correlation with SLC (r = 0.659, p less than 0.05). In conclusion, the application of PEEPe equal to the AP causes a moderate increase in EELV. However, in patients with high pulmonary compliance this increase can be more important and must be taken into account when considering the use of PEEPe during weaning.