Intensive care medicine
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Intensive care medicine · Jul 1997
Angioedema: the role of ACE inhibitors and factors associated with poor clinical outcome.
We sought to study the prevalence of angiotensin-converting enzyme (ACE) inhibitors, a cause of angioedema, and investigate any association between clinical findings at the time of presentation and clinical outcome. ⋯ ACE inhibitors are the number one cause of acute angioedema in this tertiary referral teaching hospital. Odynophagia and tongue swelling at the time of presentation had significant implications for diagnostic intervention and admission to the hospital.
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Intensive care medicine · Jul 1997
Comparative Study Clinical TrialMeasurement of cardiac output by transesophageal echocardiography in mechanically ventilated patients. Comparison with thermodilution.
The determination of basal cardiac output (CO) and of its variations during different therapeutic interventions liable to increase or decrease it in mechanically ventilated patients using transesophageal echocardiography (TEE). ⋯ These results suggest that although transesophageal CO measurements cannot replace thermodilution ones, the determination of CO variations obtained using TEE may be useful in the management of critically ill mechanically ventilated patients. This technique may make it possible to monitor hemodynamics during initial therapeutic interventions in those patients in whom right heart catheterization cannot be performed immediately.
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To develop a simplified Therapeutic Intervention Scoring System (TISS) based on the TISS-28 items and to validate the new score in an independent database. ⋯ NEMS is a suitable therapeutic index to measure nursing workload at the ICU level. The use of NEMS is indicated for: (a) multicentre ICU studies; (b) management purposes in the general (macro) evaluation and comparison of workload at the ICU level; (c) the prediction of workload and planning of nursing staff allocation at the individual patient level.
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Intensive care medicine · Jul 1997
Clinical Trial Controlled Clinical TrialThe effect of dobutamine infusion on splanchnic blood flow and oxygen transport in patients with acute pancreatitis.
To measure the blood flow distribution and oxygen transport in pancreatitis and to evaluate the regional effects of increased systemic blood flow. ⋯ In severe pancreatitis, oxygen consumption is increased in the splanchnic region; increased splanchnic oxygen demand is not always met by adequately increased blood flow. Increasing the systemic blood flow with dobutamine does not improve perfusion in the splanchnic bed.
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Intensive care medicine · Jul 1997
Case ReportsAcute colonic pseudoobstruction (Ogilvie's syndrome) in two patients receiving high dose clonidine for delirium tremens.
We describe two cases of severe colonic pseudo-obstruction (Ogilvie's Syndrome) after high dose clonidine i.v. infusions for delirium tremens. The first symptoms occurred 36 h and 5 days, respectively, after institution of therapy. ⋯ We conclude that the therapy of delirium tremens with high i.v. doses of clonidine carries the risk of provoking severe CPO, especially when other contributing factors are present. While therapy of the alcohol withdrawal syndrome with clonidine appears to be an attractive alternative to conventional treatment, ICU physicians should be alerted to this potentially serious complication.