Intensive care medicine
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Intensive care medicine · Feb 1995
Comparative StudyTreatment of surgical and non-surgical septic multiorgan failure with bicarbonate hemodialysis and sequential hemofiltration.
Hospital mortality of patients with septic multiorgan failure (MOF) is still around 95%. The present study investigates whether this high mortality could be significantly reduced by the addition of sequential hemofiltration (SH) with bicarbonate hemodialysis (HD) to the currently used life supportive measures. ⋯ Mortality observed in this retrospective, uncontrolled study was significantly lower than that currently observed with conventional supportive therapy, with or without the addition of other forms of blood purification, e.g. CAVH and CAVHD. This improvement in results appears to be related to the property of SH to completely clear 90% of the blood from mediators of inflammation in only one passage through the hemofilter, and to better tolerance of HD done using bicarbonate buffer. A definite evaluation of this technique will be eventually reached by a programmed, appropriate sample size study, which is out of reach for one individual ICU.
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Intensive care medicine · Feb 1995
Review Comparative StudyCharacteristics of the ventilator pressure- and flow-trigger variables.
Pressure- and flow-triggering are available in the Puritan Bennett 7200ae and Siemens SV 300. Using a mechanical lung model, we described the characteristics of the pressure- and flow-triggered continuous positive airway pressure (CPAP) of both ventilators. In the Puritan Bennett 7200ae, the pressure-triggered CPAP is characterized by the relatively insufficient flow delivery after the triggering, resulting in a greater lung pressure-time product (total PTP) than the flow-triggered CPAP. ⋯ Total PTP is less with pressure- or flow-triggered CPAP of the Siemens SV 300 than that of the Puritan Bennett 7200ae, respectively. The application of small pressure- or flow-triggered pressure support in the Puritan Bennett 7200ae eliminates the difference. The impact of these differences on patient inspiratory muscle work remains to be determined.
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Intensive care medicine · Feb 1995
Comparative StudyClinical validation of the Deltatrac monitoring system in mechanically ventilated patients.
To evaluate a monitor of pulmonary gas exchange (Deltatrac, Datex) in a clinical setting. ⋯ The Deltatrac appears suitable for VO2 and VCO2 measurements in ventilated patients and equivalent to a mass-spectrometer system for long term measurements.
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Successful resuscitation of the brain requires unimpaired blood recirculation. The study addresses the question of the severity and reversibility of no-reflow after cardiac arrest. ⋯ Our observations demonstrate that resuscitation of the heart by closed chest massage causes severe (and after prolonged cardiac arrest irreversible) no-reflow of the brain. This suggests that no-reflow is an important cause of post-resuscitation brain pathology.