Intensive care medicine
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Intensive care medicine · Aug 1999
Comparative Study Clinical Trial Controlled Clinical TrialProportional assist versus pressure support ventilation: effects on breathing pattern and respiratory work of patients with chronic obstructive pulmonary disease.
To investigate the breathing pattern and the inspiratory work of breathing (WOB(I)) in patients with chronic obstructive pulmonary disease (COPD) assisted with proportional assist ventilation (PAV) and conventional pressure support ventilation (PSV). ⋯ Mean values of breathing pattern did not differ by a large amount between the investigated modes. However, the higher variability of V(T) during PAV indicates an increased ability of the patients to control V(T) in response to alterations in respiratory demand. A reduction in assist during PAV(50) resulted in an increase in WOB and indices of patient effort.
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Intensive care medicine · Aug 1999
Comparative Study Clinical TrialComparison of pulmonary artery and arterial thermodilution cardiac output in critically ill patients.
We studied the agreement between cardiac output measurements via pulmonary artery thermodilution [CO(PA)], regarded as the current clinical gold standard, and aortic transpulmonary thermodilution [CO(AORTA)]. ⋯ Cardiac output derived from aortic transpulmonary thermodilution is suitable for measurement in the intensive care unit. Measurements of CO(AORTA) are consistent with, but slightly higher than, those obtained from pulmonary artery thermodilution.
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Intensive care medicine · Aug 1999
Outcome of critically ill patients treated with intermittent high-volume haemofiltration: a prospective cohort analysis.
To evaluate intervention and outcome in critically ill patients treated with high-volume haemofiltration (HV-HF). ⋯ Mortality in HV-HF patients was lower than that predicted by illness severity scores, as was the case in all patients in our ICU. Treatment with HV-HF appears to be safe and feasible. The efficacy of HV-HF should be tested in randomised, controlled trials of suitable power.
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Intensive care medicine · Aug 1999
Case ReportsDelayed admission for ethylene glycol poisoning: lack of elevated serum osmol gap.
In the absence of an immediately available serum ethylene glycol (EG) assay, the diagnosis of EG poisoning is usually based on anamnesis, clinical findings and presence of metabolic acidosis with elevated serum anion gap, elevated serum osmol gap, hypocalcemia and crystalluria. We report two cases of EG poisoning, both presenting without an elevated serum osmol gap and we discuss conditions which facilitate such a presentation, especially delayed hospital admission. Finally, we confirm the fact that determination of the osmol gap can fail as a screen for EG poisoning.