Intensive care medicine
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Intensive care medicine · Dec 2001
Randomized Controlled Trial Comparative Study Clinical TrialEndocrine effects of dopexamine vs. dopamine in high-risk surgical patients.
To compare the endocrine effects of dopexamine and dopamine on prolactin (PRL), dihydroepiandrosterone sulfate (DHEAS), cortisol, thyrotropin (TSH), and peripheral thyroid hormone serum concentrations in surgical patients at risk of developing postoperative complications because of hypoperfusion of various organ systems. ⋯ Routine postoperative optimizing of men undergoing abdominal surgical procedures with dopexamine at higher doses or dopamine induces at least partial hypopituitarism, which may possibly affect postoperative morbidity.
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Intensive care medicine · Dec 2001
Case ReportsEnoxaparin-associated severe retroperitoneal bleeding and abdominal compartment syndrome: a report of two cases.
To describe a complication of low-molecular-weight heparin (enoxaparin) in the setting of critically ill patients. ⋯ High-risk patients receiving low-molecular-weight heparin should be identified and closely monitored to prevent serious bleeding complications.
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Intensive care medicine · Dec 2001
The impact of delirium in the intensive care unit on hospital length of stay.
To determine the relationship between delirium in the intensive care unit (ICU) and outcomes including length of stay in the hospital. ⋯ In this patient cohort, the majority of patients developed delirium in the ICU, and delirium was the strongest independent determinant of length of stay in the hospital. Further study and monitoring of delirium in the ICU and the risk factors for its development are warranted.
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Intensive care medicine · Dec 2001
Comparative StudyActivation of the fibrinolytic system and utilization of the coagulation inhibitors in sepsis: comparison with severe sepsis and septic shock.
To determine whether the fibrinolytic system is activated and coagulation inhibitors are utilized in sepsis, to compare the findings detected in sepsis with those found in severe sepsis and septic shock, and to compare the role played by different infectious pathogens on fibrinolysis and coagulation inhibitors. ⋯ Fibrinolysis is strongly activated and ATIII is utilized in sepsis. These findings are further enhanced in severe sepsis and septic shock. In sepsis only ATIII is decreased. In contrast, in severe sepsis and mainly in septic shock plasminogen and the main coagulation inhibitors (i.e., ATIII, PrC) are depleted, indicating exhaustion of fibrinolysis and coagulation inhibitors. Finally, Gram-positive, Gram-negative and other micro-organisms produce identical impairment.
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Intensive care medicine · Dec 2001
Clinical TrialIndependent lung ventilation in patients with unilateral pulmonary contusion. Monitoring with compliance and EtCO(2).
a) to describe a non-barotraumatic ventilatory setting for independent lung ventilation (ILV); b) to determine the utility of single lung end-tidal CO(2) (EtCO(2)) monitoring to evaluate the ventilation to perfusion (V/Q) matching in each lung during ILV and for ILV weaning. ⋯ a) during ILV, adequate oxygenation and a reduction in V/Q mismatch can be obtained by setting Vt and PEEP to keep Pplat below a safe threshold for barotrauma; b) measurement of single lung EtCO2 can be useful to evaluate progressive V/Q matching.