Intensive care medicine
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Intensive care medicine · Aug 1998
Patterns of neurophysiological abnormality in prolonged critical illness.
To describe the various patterns of neurophysiological abnormalities which may complicate prolonged critical illness and identify possible aetiological factors. ⋯ Neurophysiological abnormalities complicating critical illness can be broadly divided into three types -- sensory abnormalities alone, a pure motor syndrome and a mixed motor and sensory disturbance. The motor syndrome could be explained by an abnormality in the most distal portion of the motor axon, at the neuromuscular junction or the motor end plate and, in some cases, by inexcitable muscle membranes or extreme loss of muscle bulk. The mixed motor and sensory disturbance which is characteristic of 'critical illness polyneuropathy' could be explained by a combination of the pure motor syndrome and the mild sensory neuropathy. More precise identification of the various neurophysiological abnormalities and aetiological factors may lead to further insights into the causes of neuromuscular weakness in the critically ill and ultimately to measures for their prevention and treatment.
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Intensive care medicine · Aug 1998
The clinical relevance of the Waterlow pressure sore risk scale in the ICU.
To evaluate whether the Waterlow pressure sore risk (PSR) scale has prognostic significance for intensive care patients. ⋯ The Waterlow PSR scale provides the medical and nursing staff at an early stage with reliable information about the risk patients have in developing a pressure sore.
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Intensive care medicine · Aug 1998
Noise sources and levels in the Evgenidion Hospital intensive care unit.
Noise sources and levels were evaluated in a six-bed intensive care unit (ICU) in Athens, Greece. Ten patients (six males, four females) completed specifically designed questionnaires, and at the same time nine 8-h sound measuring sessions took place. A Bruel and Kjaer 2231 sound-meter was used on the decibel-A scale combined with observation. ⋯ No reliable information was obtained from the questionnaires. ICU noise levels were higher by 27 dB(A) than recommended hospitals levels. To counteract noise pollution in ICUs, staff awareness and sensitivity are needed.
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Intensive care medicine · Aug 1998
Effect of enteral versus parenteral feeding on hepatic blood flow and steady state propofol pharmacokinetics in ICU patients.
The main objective of this study was to evaluate the effect of switching from parenteral to enteral feeding on liver blood flow and propofol steady-state blood concentrations in patients in the intensive care unit (ICU). ⋯ Liver blood flow and systemic clearance of propofol were not affected by switching from parenteral to enteral feeding in the eight ICU patients studied. Extrahepatic clearance accounted for at least two thirds of the overall systemic clearance of propofol.
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Intensive care medicine · Aug 1998
An investigation into the effects of midazolam and propofol on human respiratory cilia beat frequency in vitro.
Patients in intensive care are known to be prone to both upper and lower respiratory tract infection. Respiratory mucus forms a barrier to infection. Mucus transport rate (MTR) depends upon both the physical properties of mucus and the action of respiratory cilia. Patients undergoing anaesthesia are known to have a reduced MTR that may be related to a depressant effect on cilia beat frequency (CBF) by anaesthetic drugs. The aim of this study was to investigate the effects of two commonly used intensive care sedative agents, midazolam and propofol, on CBF using human nasal turbinate explants in vitro. ⋯ We have found no effect of midazolam or propofol in supra-clinical concentrations upon CBF in human turbinate explants after a 90-min exposure. This contrasts with previous work that has shown a depressant effect of inhalational anaesthetic agents on CBF.