Intensive care medicine
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Intensive care medicine · Nov 1995
Editorial Comment ReviewWasted efforts and dyssynchrony: is the patient-ventilator battle back?
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Intensive care medicine · Nov 1995
The impact of HIV testing on blood utilization in the intensive care unit in patients with gastrointestinal bleeding.
To determine whether the AIDS epidemic has influenced physician use of blood products in intensive care unit management of gastrointestinal hemorrhage. ⋯ These data indicate that physicians are transfusing patients at lower hemoglobin levels than they did before the beginning of HIV testing. However, there has been no decrease in the total median amount of blood products transfused since that time. This change in practice may be due to increased concern about HIV transmission through blood products and suggests the need for greater awareness of existing transfusion guidelines.
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Intensive care medicine · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effects of pressure support ventilation delivered by three different ventilators during weaning from mechanical ventilation.
To compare the effects of pressure support ventilation (PSV) delivered at the same level by three different ventilators on patients' work of breathing (WOB), breathing pattern and gas exchange. ⋯ During PSV, the different working principles of different mechanical ventilators profoundly affect patient's WOB. Among the various factors, velocity of pressurization of PSV may play a role in its efficacy in unloading the respiratory muscles.
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Intensive care medicine · Nov 1995
Comparative Study Clinical Trial Controlled Clinical TrialEffect of low-level PEEP on inspiratory work of breathing in intubated patients, both with healthy lungs and with COPD.
Evaluation of low-level PEEP (5 cm H2O) and the two different CPAP trigger modes in the Bennett 7200a ventilator (demand-valve and flow-by trigger modes) on inspiratory work of breathing (Wi) during the weaning phase. ⋯ We conclude that the application of low-level external PEEP benefits COPD patients because it reduces inspiratory work, mainly by lowering the inspiratory threshold represented by PEEPidyn. Differences between the trigger modes of the ventilator used in this study were small and can be compensated for by the application of a small amount of pressure support.
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Intensive care medicine · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialTopical upper airway anaesthesia with lidocaine increases airway resistance by impairing glottic function.
To assess if two different forms of upper airway topical anaesthesia induce similar changes in airway flow resistance (Rrs). ⋯ Topical upper airway anaesthesia transiently increases Rrs with no specific effects regarding the drug presentation. Laryngeal dysfunction may be one mechanisms involved in Rrs increase following upper airway topical anaesthesia. Such findings may explain some poor respiratory tolerance reported during endoscopy.