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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Intensive care medicine · Feb 2001
Use of a personal diary written on the ICU during critical illness.
To explore the use of a diary as an aid in debriefing patients and relatives following critical illness. ⋯ A detailed narrative of the patient's stay is a useful tool in the debriefing process following intensive care.
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Intensive care medicine · Feb 2001
Hepatic oxygen exchange and energy metabolism in hyperdynamic porcine endotoxemia: effects of the combined thromboxane receptor antagonist and synthase inhibitor DTTX30.
We compared the effects of thromboxane receptor antagonist and synthase inhibitor DTTX30 on systemic and liver blood flow, oxygen (O2) exchange and energy metabolism during 24 h of hyperdynamic endotoxemia with untreated endotoxemia. ⋯ DTTX30 significantly attenuated the endotoxin-induced derangements of cellular energy metabolism as reflected by the diminished progressive decrease in hepatic lactate uptake rate and a blunted increase in hepatic venous lactate/pyruvate ratios. While endotoxin significantly increased the endogenous glucose production (EGP) rate, EGP returned towards baseline levels in the DTTX30-treated group. Thus, in our model DTTX30 resulted in hemodynamic stabilization concomitant with improved hepatic metabolic performance.
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Intensive care medicine · Feb 2001
Impact of appropriateness of initial antibiotic therapy on the outcome of ventilator-associated pneumonia.
To evaluate the impact of appropriate initial antibiotic therapy (AB) on the outcome of ventilator-associated pneumonia (VAP). ⋯ Inappropriate initial AB of VAP during the first 48 h increased ICU length of stay after VAP diagnosis and tended to increase crude hospital mortality despite equal severity of illness at the time of VAP diagnosis, when compared to appropriate initial AB in a population of 111 ICU patients.