Intensive care medicine
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Intensive care medicine · Aug 1995
Safety of tracheotomy in neutropenic patients: a retrospective study of 26 consecutive cases.
To evaluate the safety of tracheotomy in neutropenic ventilated cancer patients, in terms of infectious and haemorrhagic complications. ⋯ These findings suggest that a tracheotomy can be safely performed in neutropenic patients requiring mechanical ventilation.
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The study was undertaken to determine if sepsis alters the pattern of vasomotion and reactive hyperaemia in the skin. ⋯ The laser Doppler flowmeter allows local rather than global haemodynamics to be studied. Abnormalities of skin blood flow control are found in sepsis, and this technique may prove useful to monitor the effects of treatment, especially if the use of laser Doppler flowmetry can be extended to other organs at risk of damage during sepsis such as gastro-intestinal mucosa.
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Changes of endothelial-related coagulation was studied in intensive care patients. ⋯ Besides plasmatic and platelet-related coagulation, endothelium-associated coagulation appears to be also important for maintenance of hemostasis. TM plasma concentrations were elevated in all our critically ill patients, particularly when sepsis was evident. This appears to be most likely due to endothelial membrane damage with increased release of membrane-bound TM into the circulating blood in these patients. The importance of the elevated plasma levels of circulating soluble TM on hemostasis in these patients is an ongoing debate and warrants further studies.