Intensive care medicine
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Intensive care medicine · Jan 2001
Letter Case ReportsLethal heart failure caused by aluminium phosphide poisoning.
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Intensive care medicine · Jan 2001
Review Practice Guideline GuidelineSource control in the management of sepsis.
The process of surgical decision making is based on both general principles that are amenable to evaluation using rigorous techniques of clinical research and the intangible element of surgical judgment that seeks to apply those principles to the care of an individual patient. The role of surgical judgment is inescapable, even though it is intrinsically subjective and recalcitrant to objective evaluation, for a host of factors modify the application of principle in each patient, and render the circumstances of a given problem sufficiently distinctive, that evidence must be tempered with common sense. We have tried to provide, through an evidence-based approach to a series of questions, the rationale for the basic principles that should guide the clinician in initiating or modifying source control, recognizing that sound clinical judgement demands, at times, that these be set aside. ⋯ Their implementation in practice, however, is more complex, and does not, as a rule, lend itself to simple algorithms that are applicable in all cases. Moreover evidence-based support for these principles is weak. In the final analysis, the elusive process of experienced surgical judgement is invaluable for all but the most straightforward problems.
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Intensive care medicine · Jan 2001
Multicenter StudyA cost-effectiveness analysis of stays in intensive care units.
To evaluate patient outcome and the efficiency of stays in intensive care units (ICUs). ⋯ This work provides medical and economic information on ICU stays in teaching hospitals and enables comparisons with other health-care options.
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Intensive care medicine · Jan 2001
Clinical TrialPattern of spontaneous breathing: potential marker for weaning outcome. Spontaneous breathing pattern and weaning from mechanical ventilation.
To quantitatively assess the spontaneous breathing (SB) pattern, during minimal ventilatory support, of patients who pass or fail weaning trials from mechanical ventilation. ⋯ The spontaneous breathing pattern during minimal mechanical ventilatory support is more chaotic in patients who failed extubation trials compared to patients who passed extubation trials. Thus, we speculate that characterizing the SB pattern during minimal ventilatory support might be a useful tool in differentiating between extubation success and failure.
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Intensive care medicine · Jan 2001
In vitro validation of a metabolic monitor for gas exchange measurements in ventilated neonates.
To evaluate the Datex Deltatrac II for measurements in neonates requiring mechanical ventilation. ⋯ Considering limits of agreement of less than +/- 20% as clinically acceptable, results for VO2 assessment indicate acceptable accuracy and precision whereas VCO2 and RQ assessments exceed this limit. Limited accuracy and precision result from detection of CO2 following dilution of expiratory gases and increased sensitivity to error propagation by Haldane equations due to the small differences between inspiratory and expiratory gas fractions.