Intensive care medicine
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Intensive care medicine · Jul 1995
Review Case ReportsLow blood flow extracorporeal carbon dioxide removal (ECCO2R): a review of the concept and a case report.
Despite advances in respiratory and critical care medicine, the mortality from ARDS remains unchanged. Recent research suggests current ventilatory therapy may produce additional lung injury, retarding the recovery process of the lung. ⋯ Low flow ECCO2R may offer advantages of less invasiveness and be suitable for early institution before ARDS becomes irreversible. We describe a patient with ARDS and severe macroscopic barotrauma supported with low flow ECCO2R resulting in significant CO2 clearance, reduction of peak, mean airway pressures and minute ventilation.
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Intensive care medicine · Jul 1995
Comparative StudyThe abbreviated injury scale as a predictor of outcome of severe head injury.
This study examined the correlation between the worst abbreviated injury scale 1990 (AIS) intracranial severity score and outcome following severe head injury. ⋯ The AIS, based on initial CT scan, provides useful prognostic information in patients with severe head injury.
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Intensive care medicine · Jul 1995
Randomized Controlled Trial Comparative Study Clinical TrialGastric emptying following brain injury: effects of choice of sedation and intracranial pressure.
To compare the effects of opioid and non-opioid sedation on gastric emptying. ⋯ Gastric emptying is not improved in patients with brain injury by avoiding morphine (1-8 mg/h) in the sedative regimen. Intracranial hypertension is associated with reduced gastric emptying.
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Intensive care medicine · Jul 1995
Clinical TrialMechanisms of postoperative prolonged plasma volume expansion with low molecular weight hydroxethy starch (HES 200/0.62, 6%).
To define the mechanisms of the stable and prolonged post-operative plasma volume expansion observed with Hydroxyethyl Starches (HES) and to determine whether a partial intravascular hydrolysis of large molecules contribute to reinforce the colloid-osmotic effect. ⋯ Initial plasma volume expansion and decrease in HES concentration agree with previously-published data. Maintenance of plasma volume expansion over 24 h was not related to a partial intravascular hydrolysis. Low elimination rate of HES, extravascular mobilization of albumin and post-operative renal adaptations were possibly the 3 main mechanisms to explain a prolonged plasma volume expansion with HES 200/0.62, 6%.
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Intensive care medicine · Jul 1995
Early jugular bulb oxygenation monitoring in comatose patients after an out-of-hospital cardiac arrest.
To determine the role of early jugular bulb oxygenation monitoring in comatose patients after cardiac arrest. ⋯ Jugular bulb oxygenation monitoring during the first few hours after cardiac arrest cannot reliably discriminate between comatose patients with a good and poor cerebral outcome. Further studies with an extended monitoring period are thus required.