Intensive care medicine
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Intensive care medicine · Dec 1996
Comparative StudyPressure-limited ventilation with permissive hypercapnia and minimum PEEP in saline-lavaged rabbits allows progressive improvement in oxygenation, but does not avoid ventilator-induced lung injury.
To determine whether pressure-limited intermittent mandatory ventilation with permissive hypercapnia and positive end-expiratory pressure (PEEP) titrated to arterial oxygen tension (PaO2) prevents or reduces acute lung injury, compared to conventional ventilation, in saline-lavaged rabbits. ⋯ This ventilatory protocol may have failed to prevent lung overdistension or it may have provided insufficient PEEP to prevent injury in this model; PEEP greater than the lower inflection point of the pressure-volume curve has been shown to prevent injury almost entirely.
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Intensive care medicine · Dec 1996
Assessment of depth of midazolam sedation using objective parameters.
To determine the relationship between the clinically evaluated depth of midazolam-induced sedation and the cardiac beat-to-beat variability (RR variability) in ICU patients in the intensive care unit (ICU). ⋯ In ICU patients, a significant correlation is found between the depth of midazolam-induced sedation as assessed by the Ramsay sedation score and RR variability, with a clinically sufficient prediction accuracy. RR variability can serve as an objective, continuously available, and non-invasive measurement to monitor midazolam-induced sedation in intubated and mechanically ventilated patients.
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Intensive care medicine · Dec 1996
Routine daily chest radiography is not indicated for ventilated patients in a surgical ICU.
To determine a) if clinical examination can accurately predict radiological change and b) if routine chest radiography is efficacious. ⋯ Clinical examination can effectively predict the need for radiography. Routine chest radiography is, therefore, not indicated for ventilated patients in our Surgical Intensive Care Unit.
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Intensive care medicine · Dec 1996
Severe community-acquired pneumonia in ICUs: prospective validation of a prognostic score.
To determine predictors of intensive care unit (ICU) mortality in patients with community-acquired pneumonia (CAP), to develop a pneumonia-specific prognostic index, and to evaluate this index prospectively. ⋯ This index, which performs well in classifying patients at high-risk of death, may help physicians in initial patient care (appropriateness of the initial antimicrobial therapy) and guide future clinical research (analysis and design of therapeutic trials).
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Intensive care medicine · Dec 1996
Intensive care management of paediatric organ donors and its effect on post-transplant organ function.
1. To document the clinical course of paediatric beating heart organ donors. 2. To evaluate the effect of the ICU management of pediatric donors on the immediate function of transplanted organs. 3. To examine the validity of current donor selection criteria. ⋯ Aggressive fluid resuscitation and management of diabetes insipidus may promote stability in paediatric organ donors. Donor cardiac arrest does not alter the ICU course or compromise post-transplant organ function. The current criteria used for donor selection failed to predict post-transplant organ function and their use may increase organ wastage.