Intensive care medicine
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Intensive care medicine · Mar 2002
Combination of venoarterial PCO2 difference with arteriovenous O2 content difference to detect anaerobic metabolism in patients.
Under conditions of tissue hypoxia total CO2 production (VCO2) should be less reduced than O2 consumption (VO2) since an anaerobic CO2 production should occur. Thus the VCO(2)/VO(2) ratio, and hence the venoarterial CO2 tension difference/arteriovenous O2 content difference ratio (DeltaPCO2/C(a-v)O2), should increase. We tested the value of the DeltaPCO2/C(a-v)O2 ratio in detecting the presence of global anaerobic metabolism as defined by an increase in arterial lactate level above 2 mmol/l (Lac+). ⋯ The DeltaPCO2/C(a-v)O2 ratio seems a reliable marker of global anaerobic metabolism. Its calculation would be helpful for a better interpretation of pulmonary artery catheter data.
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Intensive care medicine · Mar 2002
Clinical TrialA new simple method for percutaneous tracheostomy: controlled rotating dilation. A preliminary report.
To describe and introduce a new technique for percutaneous dilational tracheostomy. ⋯ The described new percutaneous dilational tracheostomy device (PercuTwist, Rüsch, Kernen, Germany) represents a single-step method with a high degree of control during dilation. So far, it appears to be a safe, quickly performed procedure with a strikingly low incidence of even small bleeding complications, thus offering an interesting new alternative for the performance of a percutaneous tracheostomy.
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Intensive care medicine · Mar 2002
Effects of prolonged mechanical ventilation and inactivity on piglet diaphragm function.
Muscle weakness is associated with immobilization, prolonged mechanical ventilation, critical illness and various critical care therapies. This study used an animal model simulating the critical care environment to investigate the effects of 5 days' mechanical ventilation and inactivity on diaphragm contractility and neurophysiologic function. ⋯ In this in-vivo model of prolonged mechanical ventilation in an intensive caring setting, 5 days of mechanical ventilation with sedation and complete diaphragm inactivity resulted in disturbed diaphragm contractility and activation, while nerve conduction and neuromuscular transmission were not affected. Based on these findings, it is likely that the changes seen occur at the level of peripheral muscle.
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Intensive care medicine · Mar 2002
One-year survival and neurological outcome after pediatric cardiopulmonary resuscitation.
Reported survival after cardiopulmonary resuscitation (CPR) in children varies considerably. We aimed to identify predictors of 1-year survival and to assess long-term neurological status after in- or outpatient CPR. ⋯ Independent determinants of long-term survival of pediatric resuscitation are location of arrest, underlying cause, and duration of CPR. Long-term survivors have little or no change in neurological status.
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Intensive care medicine · Mar 2002
Analysis of resource use and cost-generating factors in a German medical intensive care unit employing the Therapeutic Intervention Scoring System (TISS-28).
Evaluation of resource use and costs of a medical intensive care unit (ICU) utilising the simplified Therapeutic Intervention Scoring System (TISS-28). ⋯ TISS-28 is a fast, reliable and readily applicable tool to identify patients receiving AT. Although total and daily costs of care were significantly higher in patients receiving AT, the difference of the daily costs was, albeit statistically significant, economically negligible. The main difference in ICU costs was attributable to ICU LOS. Therefore cost-saving strategies must aim at reducing ICU LOS, without compromising quality of care.