Intensive care medicine
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Intensive care medicine · Apr 2000
Randomized Controlled Trial Clinical TrialDose-dependent effects of almitrine on hemodynamics and gas exchange in an animal model of acute lung injury.
To determine the dose-response relationship of almitrine (Alm) on pulmonary gas exchange and hemodynamics in an animal model of acute lung injury (ALI). ⋯ In experimental ALI, effects of almitrine on oxygenation are dose-dependent. Almitrine is most effective when used at low doses known to mimic hypoxic pulmonary vasoconstriction.
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Intensive care medicine · Apr 2000
Comparative StudyFunctioning of ICU ventilators under hyperbaric conditions--comparison of volume- and pressure-controlled modes.
To evaluate the function of four currently available, not specifically modified time-cycled ICU ventilators (EVITA 4, Oxylog 2000 HBO and Microvent from Drägerwerk, Germany and Servo 900C, Siemens-Elema, Sweden) under hyperbaric conditions using volume-controlled ventilation (VCV) and, if available, pressure-controlled ventilation (PCV). ⋯ Whenever available, PCV should be preferentially used during hyperbaric oxygen therapy due to the stability of ventilator functioning. Based on the specific ventilator properties at increasing ambient pressures, appropriate corrections should be possible which will allow the safe use of ICU ventilators even during VCV.
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Intensive care medicine · Apr 2000
Comparative StudyNon-invasive ventilatory approach to treatment of acute respiratory failure in neuromuscular disorders. A comparison with endotracheal intubation.
Prospectively to investigate the efficacy of non-invasive positive pressure ventilation (NPPV) combined with cricothyroid "mini-tracheostomy" (CM) as a first-line intervention in patients with acute respiratory failure (ARF) of neuromuscular origin, in comparison with positive pressure ventilation (PPV) via endotracheal intubation (ETI). ⋯ Non-invasive positive pressure ventilation in combination with CM may be considered as a safer and more effective alternative to ETI in the treatment of patients with neuromuscular disorders (NMD) who develop ARF and require MV; nevertheless, patient selection remains important, since a significant proportion of neuromyopathic patients might have to be excluded from NPPV because of severe risk of aspiration.
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Intensive care medicine · Apr 2000
Effect of positive end-expiratory pressure on splanchnic perfusion in acute lung injury.
To evaluate the acute effects of an increased positive end-expiratory pressure (PEEP) on splanchnic tissue perfusion. ⋯ PEEP by itself does not have a consistent effect on splanchnic blood flow and metabolism when cardiac index is stable and patients are ventilated within the linear part of the pv curve.
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Intensive care medicine · Apr 2000
Atropine test and circulatory arrest in the fossa posterior assessed by transcranial Doppler.
To evaluate whether a negative atropine test (i.e., increase in heart rate of less than 3% after intravenous administration of 3 mg atropine) correctly predicts circulatory arrest in the fossa posterior during craniocaudal herniation in patients with primary supratentorial lesions. ⋯ A negative atropine test indicates a circulatory arrest in the fossa posterior in patients with primary supratentorial lesions and craniocaudal herniation. In patients with brain-stem lesions, however, a negative atropine test does not unequivocally indicate a circulatory arrest.