Intensive care medicine
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Intensive care medicine · Jan 1999
Admission patterns and outcomes in a paediatric intensive care unit in South Africa over a 25-year period (1971-1995).
To describe admission and outcome patterns of diseases managed at a paediatric intensive care unit (PICU) in a developing country between 1971 and 1995, in order to provide data which will assist in improving the management of diseases and the rational allocation of health resources. ⋯ The profile of diseases in children admitted to this PICU has changed considerably over 25 years. Some of these changes can be attributed to the shift in emphasis to primary health care, especially higher vaccination coverage rates. Profitable utilisation of limited ICU facilities would probably be enhanced by the use of outcome measures such as mortality and mean number of ICU days of stay per survivor.
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Intensive care medicine · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized comparison of conventional mechanical ventilation and very early high frequency oscillatory ventilation in extremely premature newborns with respiratory distress syndrome.
To compare the effectiveness and safety of very early high-frequency oscillatory ventilation (HFOV) with conventional mechanical ventilation (CMV) in treatment of the respiratory distress syndrome (RDS) and to evaluate their impact on the incidence of chronic pulmonary disease and early and late morbidity of very low-birthweight neonates. ⋯ HFOV, when applied early and when the clinical strategy of maintenance of optimal lung volume is used, improves oxygenation in the acute stage of RDS, reduces the need of surfactant administration, and can decrease the injury to lung tissue even in extremely immature newborns to whom surfactant is administered therapeutically.
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Intensive care medicine · Jan 1999
Clinical Trial Controlled Clinical TrialImprovement in oxygenation by prone position and nitric oxide in patients with acute respiratory distress syndrome.
Inhaled nitric oxide (NO) and prone position improve arterial oxygenation in patients with the acute respiratory distress syndrome. This study was undertaken to assess the combined effects of NO and prone position in these patients. ⋯ In patients with the acute respiratory distress syndrome, the combination of NO and prone position is a valuable adjunct to mechanical ventilation.
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Intensive care medicine · Jan 1999
Randomized Controlled Trial Clinical TrialSpontaneous variability of arterial oxygenation in critically ill mechanically ventilated patients.
To assess the magnitude of spontaneous variability of arterial oxygenation and oxygen tension-based indices over time in medical intensive care unit (ICU) patients and to study whether high positive end-expiratory pressure (PEEP) or inverse inspiratory-to-expiratory (I:E) ratio ventilation (IRV) results in a greater variability than low PEEP with conventional I:E ratio ventilation. ⋯ In critically ill medical ICU patients, despite sedation, the spontaneous variability in PaO2 over time is substantial. A high PEEP or IRV does not contribute to the increased variation in PaO2.
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Intensive care medicine · Jan 1999
Comparative Study Clinical TrialEffect of inhaled nitric oxide on respiratory mechanics in ventilated infants with RSV bronchiolitis.
To evaluate the bronchodilator effect of inhaled nitric oxide (NO) in infants with respiratory failure caused by respiratory syncytial virus (RSV) bronchiolitis and to compare the effect with the one obtained by salbutamol. ⋯ Inhaled NO has no apparent bronchodilator effect in the majority of acutely ill infants with RSV bronchiolitis and does not appear to provide any additional benefit over the use of salbutamol. The clinical benefit of inhaled NO as a bronchodilator is questionable under these conditions.