Intensive care medicine
-
Intensive care medicine · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialRespiratory comfort of automatic tube compensation and inspiratory pressure support in conscious humans.
To compare the new mode of ventilatory support, which we call automatic tube compensation (ATC), with inspiratory pressure support (IPS) with respect to perception of respiratory comfort. ATC unloads the resistance of the endotracheal tube (ETT) in inspiration by increasing the airway pressure, and in expiration by decreasing the airway pressure according to the non-linear pressure-flow relationship of the ETT. ⋯ ATC provides an increase in respiratory comfort compared with IPS. The predominant cause for respiratory discomfort in the IPS mode seems to be lung over-inflation.
-
Intensive care medicine · Nov 1997
Comparative Study Clinical TrialNon-invasive measurement of cardiac output: whole-body impedance cardiography in simultaneous comparison with thermodilution and direct oxygen Fick methods.
To determine the reliability of whole-body impedance cardiography (ICGWB), with electrodes attached to wrists and ankles, in the measurement of cardiac output (CO) on the basis of simultaneous comparison with thermodilution (TD) and direct oxygen Fick (Fick) methods. ⋯ There was close agreement between the results of the three methods in the measurement of CO. In sedated preoperative patients the accuracy of ICGWB is within clinically acceptable limits and its repeatability is excellent. ICGWB provides a useful alternative to the TD and Fick methods in cases where the pressures supplied by the pulmonary artery catheter are not essential.
-
Intensive care medicine · Nov 1997
Comparative StudyEffects of early treatment with immunoglobulin on critical illness polyneuropathy following multiple organ failure and gram-negative sepsis.
The evaluation of incidences and relating factors of severe persisting critical illness polyneuropathy (CIP) in survivors of multiple organ failure (MOF). ⋯ A high incidence of severe CIP persisting until the day of discharge from the ICU was related to gram-negative sepsis but not to MOF alone. Retrospective chart analysis suggested that early application of IVIG may prevent or mitigate this severe complication. However, these results have to be confirmed in a prospective, placebo-controlled study.
-
Intensive care medicine · Nov 1997
The association between blood lactate concentration on admission, duration of cardiac arrest, and functional neurological recovery in patients resuscitated from ventricular fibrillation.
To assess the association between arterial lactate concentration on admission and the duration of human ventricular fibrillation cardiac arrest, and to what degree the arterial lactate concentration on admission is an early predictor of functional neurological recovery in human cardiac arrest survivors. ⋯ The arterial admission lactate concentration after out-of-hospital ventricular fibrillation cardiac arrest is a weak measure of the duration of ischemia. High admission lactate levels are associated with severe neurological impairment. However, this parameter has poor prognostic value for individual estimation of the severity of subsequent functional neurological impairment.
-
Intensive care medicine · Nov 1997
Clinical Trial Controlled Clinical TrialThe influence of antithrombin III (AT III) substitution to supranormal activities on systemic procoagulant turnover in patients with end-stage chronic liver disease.
Since antithrombin III (AT III) substitution to normal activities could not be shown to have major beneficial effects in patients with end-stage chronic liver disease in a variety of clinical settings, we tested the hypothesis that substitution to supranormal activities decreases systemic procoagulant turnover better in this patient group. ⋯ Despite thrombin inhibition by AT III in patients with end-stage chronic liver disease, systemic procoagulant turnover was not significantly decreased 60 min after AT III application even to supranormal activities. Replenishment of the inhibitory antithrombin III pool, decreased in chronic liver disease, should not be expected to slow down the baseline consumptive component of the haemostatic disorder in this patient group.