Intensive care medicine
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Intensive care medicine · Aug 1996
Clinical TrialRight ventricular myocardial function in ARF patients. PEEP as a challenge for the right heart.
To examine the hemodynamic effects of external positive end-expiratory pressure (PEEP) on right ventricular (RV) function in acute respiratory failure (ARF) patients. ⋯ PEEP affects RV function in ARF patients. The decrease in cardiac output is more often associated with a preload decrease and no change in RV contractility. On the other hand, the finding of increased RV volumes with PEEP may be associated with a reduction in RV myocardial performance. Thus, these results suggest that assessment of RV function by PEEP and preload recruitable stroke work may disclose otherwise unpredictable alterations in RV function.
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To review the technology, clinical trials and current status of continuous blood gas monitoring in intensive care. ⋯ Over the past 10 years a number of continuous intra-arterial blood gas monitoring systems have been developed. The performance characteristics of these systems are comparable. Their levels of accuracy as measured in bench tonometry are not consistently achieved in clinical trials. The potential usefulness of these monitors in various clinical situations has been described in case studies. Controlled studies demonstrating an improvement in outcome with the use of these monitors have not been published.
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Intensive care medicine · Aug 1996
Early and late onset bacteremia have different risk factors in trauma patients.
The aim of this study was to identify risk factors and to describe epidemiological patterns for early-(EOB) and late-onset bacteremias (LOB) after trauma. ⋯ Scoring with the AIS of the abdominal and thoracic trauma at admission to the ICU appears a useful tool for identifying trauma patients at increased risk of EOB. A rigorous policy of catheter placement and maintenance as a means of reducing late bacteremias in trauma patients is essential.
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To evaluate the prevalence of serum and erythrocyte magnesium (Mg) abnormalities in patients on admission to the intensive care unit (ICU) and to test the hypothesis that low levels of Mg are associated with a higher mortality. ⋯ We confirm the high prevalence of Mgs abnormalities as well as Mg deficiency on admission to a medical ICU. Low levels of Mgs and Mge are not associated with higher fatality. HyperMgs was associated with patient death.
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Intensive care medicine · Aug 1996
Haemodynamic and respiratory conditions during alternating and synchronous ventilation of both lungs.
We tested the hypothesis that mean thoracic expansion (and mean lung volume) is lower during alternating ventilation (AV), i.e. ventilation of both lungs with a phase shift of half a ventilatory cycle, compared to synchronous ventilation (SV) of both lungs. As a consequence, intrathoracic pressure will be lower, causing lower, central venous pressure and higher cardiac output. ⋯ Our data verified the hypothesis. The lower oesophageal (series 1), pericardial (series 2) and central venous pressures during AV compared to SV could be explained by the smaller thoracic expansion due to the lower mean lung volume, which was attributed to compression of the opposite lung by the, expansion of the inflated lung.