Intensive care medicine
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Intensive care medicine · Sep 1998
Multicenter Study Comparative StudyA profile of European ICU nursing.
To evaluate major similarities and major differences between Western European countries in intensive care unit (ICU) nurse staffing, education, training, responsibilities, and initiative. ⋯ Even though the number of participants were limited, our questionnaire revealed variations in nurse staffing patterns among European countries and in their systems of training and education. Nurse autonomy also varies widely between countries.
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Intensive care medicine · Sep 1998
Influence of mechanical ventilation on blood lactate in patients with acute respiratory failure.
To determine whether mechanical ventilation (MV) may affect blood lactate concentration in patients with acute respiratory failure. ⋯ Controlled MV decreases substantially the severity of hyperlactatemia in patients with acute respiratory failure, and any adverse circulatory effects of MV do not alter this beneficial outcome.
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Intensive care medicine · Sep 1998
The use of intensive care information systems alters outcome prediction.
To study the effect of using an Intensive Care Information System (ICIS) on severity scores and prognostic indices: Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), and Mortality Probability Models II (MPM II). ⋯ The use of ICIS charting to acquire the most abnormal physiologic values for severity scores and the derived prognostic indices results in a higher mortality prediction. Comparison of groups of patients and/or ICUs based on severity scores is impossible without standardization of data collection. The mortality prediction models have to be revalidated for the use of ICIS charting. While awaiting this, we suggest that every patient record in local regional, national, or international ICU databases should be marked as being recorded by manual or by ICIS charting.
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Intensive care medicine · Sep 1998
Systemic pressure-flow reactivity to norepinephrine in rabbits: impact of endotoxin and fluid loading.
This study aimed to evaluate the impact of fluid loading on hemodynamics and vascular hypocontractility to norepinephrine (NE) in an endotoxic shock model. ⋯ Fluid loading transformed the hypodynamic profile of endotoxic shock into a hyperdynamic state without improving blood pressure. Depressed vascular reactivity to NE was observed in both hyperdynamic and hypodynamic states, suggesting that a reduced vascular reactivity does not necessarily imply systemic vasodilation.
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Intensive care medicine · Sep 1998
Work of breathing, inspiratory flow response, and expiratory resistance during continuous positive airway pressure with the ventilators EVITA-2, EVITA-4 and SV 300.
To analyze work of breathing (WOB) imposed by the respirators EVITA-2, EVITA-4 (Drägerwerk, Lübeck, Germany) and SV 300 (Siemens-Elema, Sweden) as well as inspiratory flow response and expiratory flow resistance during continuous positive airway pressure (CPAP). ⋯ Under similar conditions, no difference in WOBimposed was observed, although inspiratory flow response and expiratory flow resistance differed substantially between the three ventilators tested. Trigger sensitivity plays a minor role in determining PTP and WOB but has major influence on flow.