Intensive care medicine
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Intensive care medicine · Jan 1999
Multicenter StudyManagement of nutrition in European intensive care units: results of a questionnaire. Working Group on Metabolism and Nutrition of the European Society of Intensive Care Medicine.
To describe the practical aspects of nutritional management in intensive care units (ICUs). ⋯ European intensivists are concerned by the nutritional management of their patients. The use of nutritional support is common, essentially as early enteral feeding.
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Intensive care medicine · Jan 1999
Noninvasive pressure support ventilation (NIPSV) with face mask in patients with acute cardiogenic pulmonary edema (ACPE)
To assess (1) the short-term hemodynamic, respiratory and arterial blood gas effects of NIPSV in patients with ACPE who were likely to require endotracheal intubation, (2) the initial causes of failure and (3) the side effects and the difficulties of this technique. ⋯ Among patients in acute respiratory failure, those with severe ACPE could benefit from NIPSV if they are hypercapnic, but NIPSV should be avoided in those with AMI.
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Intensive care medicine · Jan 1999
Endotoxin inhibits heat shock protein 70 (HSP70) expression in peripheral blood mononuclear cells of patients with severe sepsis.
To investigate the ex vivo endotoxin-inducible heat shock protein 70 (HSP70) expression in the peripheral blood mononuclear cells (PBMC) of patients with severe sepsis in order to assess the capacity of this potentially protective response during systemic inflammation. ⋯ Endotoxin inhibits HSP70 expression in PBMC ex vivo. In vivo, the suppression of HSP70 expression induced by endotoxin and high levels of proinflammatory cytokines may contribute to the cellular dysfunction of immunocompetent cells concerning antigen presentation, phagocytosis and antibody production associated with decreased resistance to infectious insults during severe sepsis.
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Intensive care medicine · Jan 1999
Clinical TrialThe pharmacokinetics of morphine and lidocaine in critically ill patients.
To evaluate the pharmacokinetic parameters of morphine and lidocaine after a single intravenous dose in critically ill patients. ⋯ Both morphine and lidocaine have a reduced volume of distribution in critically ill patients. The normal lidocaine clearance indicates preserved hepatic blood flow and suggests that other mechanisms are involved in the reduced morphine clearance. These findings may have application for the treatment of ICU patients.
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T helper 1 (Thl) lymphocytes produce interferon gamma (IFNgamma), favouring cell mediated immunity; Th2 cells secrete interleukin-4 (IL-4), favouring humoral immunity. Cytokines produced in sepsis may effect Th subset predominance and subsequent immune responses. ⋯ In patients with sepsis, Th2 antibody mediated (humoral) immune responses predominate. This type of response may lead to fibroblast activation and ultimately immunosuppression. Modulation of Th cell subset predominance may present a novel therapeutic option in the treatment of severe sepsis.