Intensive care medicine
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Intensive care medicine · Aug 1998
Review Practice Guideline GuidelineEnteral nutrition in intensive care patients: a practical approach. Working Group on Nutrition and Metabolism, ESICM. European Society of Intensive Care Medicine.
Severe protein-calorie malnutrition is a major problem in many intensive care (ICU) patients, due to the increased catabolic state often associated with acute severe illness and the frequent presence of prior chronic wasting conditions. Nutritional support is thus an important part of the management of these patients. ⋯ However, clinicians caring for ICU patients are often faced with contradictory data and difficult decisions when having to determine the optimal timing and modalities of EN administration, estimation of patient requirements, and choice of formulas. The purpose of this paper is to provide practical guidelines on these various aspects of enteral nutritional support, based on presently available evidence.
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Intensive care medicine · Aug 1998
Randomized Controlled Trial Clinical TrialGastric intramucosal pH-guided therapy in patients after elective repair of infrarenal abdominal aneurysms: is it beneficial?
To determine if gastric intramucosal pH (pHi)-guided therapy reduces the number of complications and length of stay in the intensive care unit (ICU) or the hospital after elective repair of infrarenal abdominal aortic aneurysms. ⋯ Low pHi values (< 7.32) and their persistence are predictors of major complications. Treatment to elevate low pHi values does not improve postoperative outcome. Based on these data, we cannot recommend the routine use of gastric tonometers for pHi-guided therapy in these patients. Further studies are warranted to determine adequate treatment of low pHi values that results in beneficial effects on the patient's postoperative course and outcome.
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Intensive care medicine · Aug 1998
Comparative Study Clinical TrialComparison of air tonometry with gastric tonometry using saline and other equilibrating fluids: an in vivo and in vitro study.
1) To compare saline gastric tonometry monitoring with air tonometry (Tonocap) in a group of general ICU patients. 2) An in vitro investigation of the performance of other fluids used in gastric tonometry and to assess the effects of variation of temperature and carbon dioxide concentration within the range encountered in clinical use. ⋯ There are clinically significant differences in values for gastric mucosal PCO2 measured by air tonometry and saline tonometry both in vivo and in vitro.
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Intensive care medicine · Aug 1998
Clinical TrialPhysiologic evaluation of non-invasive pressure support ventilation in trauma patients with acute respiratory failure.
To investigate the effectiveness of noninvasive (face mask) versus invasive (endotracheal tube) equal pressure values on blood gases and respiratory pattern and to evaluate the feasibility of using mask ventilation after the short term physiologic study. ⋯ NIPSV is comparable to IPSV in terms of blood gases and respiratory pattern. The clinical uncontrolled study indicates that NIPSV could be used in selected trauma patients.