Intensive care medicine
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Intensive care medicine · May 2002
Effects of acid-base abnormalities on blood capacity of transporting CO2: adverse effect of metabolic acidosis.
Objective. To investigate the effects of some acid-base abnormalities on blood capacity of transporting CO2. Design. ⋯ Conclusions. Our findings suggest that acid-base abnormalities, particularly metabolic acidosis, markedly affect blood capacity of transporting CO2 and may worsen tissue hypercarbia associated with hypoperfusion. However, because of possible errors due to small measurements and the assumptions of the method, in the future definitive clarification will require the construction of original CO2 dissociation curves for each acid-base abnormality.
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Intensive care medicine · May 2002
Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation.
To assess the relationship between the time period before hyperbaric oxygenation therapy (HBO) and clinical outcome in patients with iatrogenic cerebral air embolism. ⋯ We stress the beneficial effect of an early HBO in air embolism, the importance of an increased awareness of physicians concerned with this severe complication, and the need to develop techniques to detect air emboli in the cerebral circulation.
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To document the effect of neurocritical care, delivered by specialist staff and based on protocol-driven therapy aimed at intracranial pressure (ICP) and cerebral perfusion pressure (CPP) targets, on outcome in acute head injury. ⋯ Specialist neurocritical care with protocol-driven therapy is associated with a significant improvement in outcome for all patients with severe head injury. Such management may also benefit patients requiring no surgical therapy, some of whom may need complex therapeutic interventions. We found it impossible to predict need for such interventions from clinical features at presentation. These data suggest that specialist critical care with ICP/CPP guided therapy may benefit patients with severe head injury.
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Intensive care medicine · May 2002
Prone positioning in acute respiratory failure: survey of Belgian ICU nurses.
To determine the frequency of use and attitudes towards prone positioning in patients with acute respiratory failure. ⋯ Prone positioning is approached with some reluctance by ICU staff. If the use of prone positioning in patients with acute respiratory distress syndrome is deemed worthwhile, discussion and development of departmental protocols may facilitate its use.