Intensive care medicine
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Intensive care medicine · Feb 1999
Case ReportsModerately severe anaphylactoid reaction to pentastarch (200/0.5) in a patient with acute severe asthma.
The use of synthetic colloids for resuscitation and volume replacement is common in the intensive care unit. Although adverse reactions have been reported to colloid solutions, the incidence of severe reactions to the starch derivatives is low. We report a case of an anaphylactoid reaction to pentastarch (200/0.5) in a young asthmatic who received it as a fluid challenge in the intensive care unit. The pathogenesis and implications of such a reaction in an asthmatic are discussed.
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Intensive care medicine · Feb 1999
Randomized Controlled Trial Comparative Study Clinical TrialContinuous thermodilution cardiac output: clinical validation against a reference technique of known accuracy.
To evaluate the accuracy and precision of continuous thermodilution (CCO) by using a validated bolus thermodilution (BCO) reference technique as criterion standard. ⋯ Decreased precision of CCO as compared to iced BCO may, in clinical settings, be outweighed by the advantages of automated and continuous monitoring. Under research conditions, however, iced BCO remains the method of choice.
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Intensive care medicine · Feb 1999
Multicenter StudyEpidemiological features and prognosis of severe community-acquired pneumococcal pneumonia.
To describe risk factors of severe pneumococcal community-acquired pneumonia and to study variables influencing outcome. ⋯ Few features facilitate the identification of pneumococcal CAP on ICU admission. The prognosis is mostly related to severity of illness (leukopenia, septic shock) while comorbidities do not seem to influence outcome. Sepsis-related disorders, ICU complications and adequate antimicrobial chemotherapy are the major variables affecting the outcome during an ICU stay.
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Intensive care medicine · Feb 1999
Randomized Controlled Trial Clinical TrialEffects of early enteral nutrition on intestinal permeability and the development of multiple organ failure after multiple injury.
To determine how immediate enteral nutrition (EN) affects gut permeability and the development of multiple organ failure (MOF) in multiply injured patients. ⋯ In contrast with normal volunteers, the patients started on EN later than 24 h after admission to the ICU demonstrated increased intestinal permeability on the second day after sustaining multiple injury. Also, they had a more severe form of MOF than the group placed on EN immediately upon admission. However, early EN had no influence on the length of ICU stay or the time of mechanical ventilation.