Intensive care medicine
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Intensive care medicine · Jun 2002
An evaluation of extubation failure predictors in mechanically ventilated infants and children.
To assess the accuracy of traditional weaning indices in predicting extubation failure, and to compare their accuracy when indices are measured at the onset of a breathing trial (SBT) and at the end of the SBT before extubation. ⋯ In a population which had passed SBT, the ability of the traditional weaning indices to discriminate between children successfully extubated and children re-intubated is very poor.
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Intensive care medicine · Jun 2002
Comparative StudyComparison of three different methods to confirm tracheal tube placement in emergency intubation.
Verification of endotracheal tube placement is of vital importance, since unrecognized esophageal intubation can be rapidly fatal (death, brain damage). The aim of our study was to compare three different methods for immediate confirmation of tube placement: auscultation, capnometry and capnography in emergency conditions in the prehospital setting. ⋯ Capnography is the most reliable method to confirm endotracheal tube placement in emergency conditions in the prehospital setting.
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Intensive care medicine · Jun 2002
Randomized Controlled Trial Clinical TrialPeer-led resuscitation training for healthcare students: a randomised controlled study.
To determine the efficacy of a peer-led tuition model for training healthcare students in basic life support compared to tuition delivered by clinical tutors. ⋯ This model of peer-led undergraduate training in basic life support provides a quality of education which is at least as good as that provided by clinical staff, while offering advantages in terms of reliability. The re-deployment of clinical tutors from basic to more advanced training may allow the overall enhancement of undergraduate resuscitation and critical care training.
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Intensive care medicine · Jun 2002
Cardiac performance during vasopressin infusion in postcardiotomy shock.
Arginine-vasopressin (AVP) might be a potent vasopressor agent in catecholamine-resistant postcardiotomy shock. However, its use remains experimental because of considerations about deleterious effects on the heart. We report on the effects of continuous AVP-infusion on cardiac performance, biomarkers of myocardial ischemia, and systemic hemodynamics in catecholamine-resistant postcardiotomy shock. ⋯ AVP was devoid of adverse effects on the heart in these patients with catecholamine-resistant postcardiotomy shock. The significant reduction in HR, vasopressor, and inotropic support suggest a substantial improvement in myocardial performance. These findings are supported by a significant decrease of cardiac enzymes and cardioversion of TA into sinus rhythm in 45.5% of patients with new-onset TA.
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Intensive care medicine · Jun 2002
Aerosolized beta(2)-adrenergic agonists achieve therapeutic levels in the pulmonary edema fluid of ventilated patients with acute respiratory failure.
Experimental studies demonstrate that beta-adrenergic agonists markedly stimulate alveolar fluid clearance if concentrations of 10(-6) M are achieved in alveolar fluid. However, no studies have determined whether aerosolized beta-adrenergic agonists are delivered to the distal air spaces of the lung in therapeutic concentrations in patients with pulmonary edema. ⋯ These results provide the first evidence that levels of beta-adrenergic agonists that are physiologically efficacious in experimental models can be achieved with conventional delivery systems in ventilated, critically ill patients with acute respiratory failure from pulmonary edema.