Intensive care medicine
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Intensive care medicine · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialKeeping central venous lines open: a prospective comparison of heparin, vitamin C and sodium chloride sealing solutions in medical patients.
To prevent catheter occlusion, intermittently used central venous catheters are frequently sealed with vitamin C solution or heparin solution between use. The present study was designed to test the effectiveness of this approach and to compare the efficiency of sealing solutions. ⋯ Local anticoagulation of intermittently used central venous catheters prolongs catheter patency. High-dose (5000 IU/ml) heparin solution is a useful anticoagulant for this purpose, while vitamin C solution does not prolong catheter patency.
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Intensive care medicine · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialInfluence of respiratory rate on gas trapping during low volume ventilation of patients with acute lung injury.
Reduction in tidal volume (Vt) associated with increase in respiratory rate to limit hypercapnia is now proposed in patients with acute lung injury (ALI). The aim of this study was to test whether a high respiratory rate induces significant intrinsic positive end-expiratory pressure (PEEPi) in these patients. ⋯ An increase in respiratory rate used to avoid Vt reduction-induced hypercapnia may induce substantial gas trapping and PEEPi in patients with ALI.
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Intensive care medicine · Aug 2002
Randomized Controlled Trial Clinical TrialProtocol-directed weaning from mechanical ventilation: clinical outcome in patients randomized for a 30-min or 120-min trial with pressure support ventilation.
To investigate the possibility of successful extubation performing a spontaneous breathing trial (SBT) in pressure support ventilation (PSV) with target durations of 30 and 120 min. ⋯ An SBT with PSV of 7 cmH(2)O lasting 30 min is equally effective in recognizing the successfully extubated patients as a 120-min trial.
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Intensive care medicine · Aug 2002
Comparative StudyInfluence of inspiration:expiration ratio on intracranial and cerebral perfusion pressure in acute stroke patients.
We undertook this study to evaluate the influence of the inspiration:expiration (I:E) ratio on intracranial pressure and cerebral perfusion in patients with acute stroke. ⋯ Our preliminary results suggest that variations of the I:E ratio cause no significant changes in intracranial or cerebral perfusion pressure and, thus, can be safely used in patients with acute stroke without intracranial hypertension. The influence of I:E ratio variations on stroke patients with intracranial hypertension remains to be evaluated.
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Intensive care medicine · Aug 2002
Randomized Controlled Trial Clinical TrialHigh values of the pulmonary artery wedge pressure in patients with acute lung injury and acute respiratory distress syndrome.
To determine the incidence and severity of pulmonary artery wedge pressure (PAWP) elevation in patients with ALI/ARDS. In addition, to examine the effects of clinical variables on the presence of a high PAWP (>18 mmHg) and the effect of an elevated PAWP on mortality. ⋯ We conclude that in this group of patients a PAWP higher than 18 mmHg is common. Mandating a PAWP of 18 mmHg or less may negatively impact clinical trials in which ARDS is an inclusion/exclusion criteria or an endpoint.