Intensive care medicine
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Intensive care medicine · Sep 1996
Evaluation of trauma care: validation of the TRISS method in an Italian ICU.
To validate the TRISS method as an audit system on a group of patients with severe trauma admitted to an Italian general intensive care unit (ICU). ⋯ The results of the validation of the TRISS method showed adequate calibration and high discriminatory power in Italian ICU trauma patients also, allowing confidence in the use of this method as an audit tool in our ICU. Some caution is advisable in extending these results to patients with operable intracranial injuries, due to the relatively low number of such cases included in the study.
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Intensive care medicine · Sep 1996
Review Comparative StudyDiagnostic and therapeutic implications of transesophageal echocardiography in medical ICU patients with unexplained shock, hypoxemia, or suspected endocarditis.
To evaluate the diagnostic and therapeutic implications of transesophageal echocardiography (TEE) in intensive care patients. ⋯ TEE is safe and well tolerated and is useful in the management of patients in the intensive care unit with shock, unexplained and severe hypoxemia, or suspected endocarditis when TTE is inconclusive.
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Intensive care medicine · Sep 1996
Effects of positive end-expiratory pressure on right ventricular function in COPD patients during acute ventilatory failure.
To examine the effects of external positive end-expiratory pressure (PEEP) on right ventricular function in chronic obstructive pulmonary disease (COPD) patients with intrinsic PEEP (PEEPi). ⋯ In COPD patients an external PEEP exceeding 90% of PEEPi causes lung hyperinflation and reduces the CI due to a preload effect. The reduction in RVEDVI seems related to changes in EELV, rather than to changes in transmural pressures, suggesting a lung/heart volume interaction in the cardiac fossa. Thus, in COPD patients, application of an external PEEP level lower than PEEPi may affect right ventricular function.
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Intensive care medicine · Sep 1996
Randomized Controlled Trial Clinical TrialPostextubation laryngeal edema in adults. Risk factor evaluation and prevention by hydrocortisone.
To evaluate the risk factors for postextubation laryngeal stridor and its prevention by hydrocortisone in adult patients. ⋯ Hydrocortisone did not significantly reduce the incidence of postextubation laryngeal edema or stridor. From the risk factors evaluated, we were unable to demonstrate a statistical correlation between postextubation stidor and the duration of the intubation, the patient's age, the internal diameter of the endotracheal tube, or the route of intubation. However, female patients were more likely to develop this complication.
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Intensive care medicine · Sep 1996
Comparative Study Clinical Trial Controlled Clinical TrialA comparison of the adrenocortical response during septic shock and after complete recovery.
To compare the adrenocortical response to corticotropin during septic shock and after complete recovery. ⋯ Adrenocortical response to corticotropin is attenuated in patients with septic shock and high-output circulatory failure compared to the response in the much less stressful condition after recovery. The attenuated adrenocortical responsiveness may be explained by effects of circulating mediators from the systemic inflammatory response.