Intensive care medicine
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Intensive care medicine · Dec 2002
Randomized Controlled Trial Comparative Study Clinical TrialNoninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial.
We conducted a randomized prospective study comparing noninvasive positive pressure ventilation (NPPV) with conventional mechanical ventilation via endotracheal intubation (ETI) in a group of patients with chronic obstructive pulmonary disease who failed standard medical treatment in the emergency ward after initial improvement and met predetermined criteria for ventilatory support. ⋯ The use of NPPV in patients with chronic obstructive pulmonary disease and acute respiratory failure requiring ventilatory support after failure of medical treatment avoided ETI in 48% of the patients, had the same ICU mortality as conventional treatment and, at 1-year follow-up was associated with fewer patients readmitted to the hospital or requiring for long-term oxygen supplementation. An editorial regarding this article can be found in the same issue (http://dx.doi.org/10.1007/s00134-002-1503-3).
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Intensive care medicine · Dec 2002
Comparative StudyPediatric intensive care: result of a European survey.
To assess and compare the structure, organisation, management, and staffing in different paediatric intensive care units (PICUs) in Europe. ⋯ Data obtained in our survey demonstrate the substantial structural, organisational management, and staff diversity of paediatric ICUs. Most European PICUs employ specialized PICU nurses and have at least part time coverage by paediatric intensivists.
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Intensive care medicine · Dec 2002
Randomized Controlled Trial Clinical TrialNorepinephrine and vital organ blood flow.
To test whether norepinephrine (NE) infusion at 0.4 microg kg(-1) min(-1) adversely affects regional blood flow in the normal mammalian circulation. ⋯ NE infusion does not induce vital organ ischaemia in the normal mammalian circulation. Furthermore, it results in a significant increase in coronary and renal blood flow with a concomitant improvement in urine output and creatinine clearance.
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Intensive care medicine · Dec 2002
Pediatric ARDS: effect of supine-prone postural changes on oxygenation.
To determine the effect of repeated prone positioning (supine-prone/prone-supine) on oxygenation in children suffering from ARDS. ⋯ The prone position improves oxygenation in a significant proportion of children with ARDS. Although no statistically significant difference was found for the mortality rate, it was higher for the non-responders (80%) vs the responders (39%).