Intensive care medicine
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Intensive care medicine · Feb 2001
Randomized Controlled Trial Clinical TrialEffects of bronchoalveolar lavage volume on arterial oxygenation in mechanically ventilated patients with pneumonia.
To assess the effect of bronchoalveolar lavage (BAL) volume on arterial oxygenation in critically ill patients with pneumonia. ⋯ A decrease in the PaO2/FIO2 ratio was observed in all patients after a combined diagnostic procedure, independent of the BAL volume used. A significant bacterial burden recovered from the alveoli and no preemptive antibiotic therapy were associated with a larger and longer-lasting decrease in arterial oxygenation.
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Intensive care medicine · Feb 2001
Randomized Controlled Trial Clinical TrialProphylactic hemofiltration in severely traumatized patients: effects on post-traumatic organ dysfunction syndrome.
To evaluate the effects of prophylactic veno-venous hemofiltration (CVVH) in the absence of renal failure on multiple organ dysfunction syndrome after severe multiple trauma. ⋯ CVVH blunts the cardiovascular response to multiple trauma and increases tissue oxygen extraction. However, the concomitant decrease in platelet counts represents a limitation for the use of prophylactic CVVH in surgical patients.
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Actin is the dominating intracellular protein and is released to the circulation after tissue injury. Gc-globulin is one of the plasma proteins responsible for removal of actin from the circulation. Recent studies have shown that the level of Gc-globulin is reduced shortly after trauma. Serial changes in Gc-globulin after severe injury have not been studied so far and could provide additional information about the role of Gc-globulin in the pathophysiological response to trauma. ⋯ Severe injury results in a prolonged load on the extracellular actin scavenger system; more pronounced in patients who do not survive. Gc-globulin displays characteristics of an acute phase reactant, with supra-normal serum levels 1 week after severe injury. Serial measurements of Gc-globulin after trauma could prove to be a method of early identification of patients with increased risk of mortality.