Intensive care medicine
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Intensive care medicine · Feb 1998
Retracted PublicationVolume replacement strategies on intensive care units: results from a postal survey.
To assess volume replacement strategies on intensive care units (ICUs) in Germany. ⋯ The kind of volume therapy differs widely among the different ICUs. This questionnaire supported the supposition that no standards exist for volume therapy in intensive care patients. New results concerning the abuse of albumin in the critically ill have not yet influenced strategies of volume replacement.
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Intensive care medicine · Feb 1998
Randomized Controlled Trial Clinical TrialEffects of human recombinant growth hormone (rhGH) on inflammatory responses in patients undergoing abdominal aortic aneurysm repair.
Human recombinant growth hormone (rhGH) has been shown to increase skeletal muscle protein synthesis and improve nitrogen balance in critically ill patients and those undergoing surgery. rhGH effects on hepatic protein turnover in critically ill patients are less clearly understood. ⋯ These results indicate that pre-operative administration of rhGH does not alter acute phase protein or inflammatory cytokine release in response to major surgery.
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To demonstrate that oxygen consumption (VO2) can be dependent on oxygen delivery (DO2) during hemodynamic instability and independent of DO2 following stabilization. ⋯ Oxygen supply independency and dependency can be found at different times in the same critically ill patient. Our findings are consistent with the concept that VO2/DO2 dependency is a marker of septic shock. Interventions to increase DO2 are probably justified when this phenomenon is present.
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Intensive care medicine · Feb 1998
Lung overinflation without positive end-expiratory pressure promotes bacteremia after experimental Klebsiella pneumoniae inoculation.
To determine the effect of peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP) on the development of bacteremia with Klebsiella pneumoniae after mechanical ventilation of intratracheally inoculated rats. ⋯ These data show that 3 h of mechanical ventilation with a PIP of 30 cmH2O without PEEP in rats promotes bacteremia with K. pneumoniae. The use of 10 cmH2O PEEP at such PIP reduces ventilation-induced K. pneumoniae bacteremia.
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Intensive care medicine · Feb 1998
Alternations of surface antigens on leukocytes after severe injury: correlation with infectious complications.
To investigate the alternations of surface antigens of leukocytes after severe injury and the correlation with clinical outcome. ⋯ Phenotypic alternations of leukocytes develop early after severe injury. The alternations may represent a state of activation of PMN and subsequent suppression of IL-2 related immunity. Persistent activation of PMN with enhanced CD11b and attenuated CD16 expression indicates the development of infectious complications and a poor prognosis can be anticipated if the infectious sites can not be controlled early.