Intensive care medicine
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Intensive care medicine · Aug 2002
Safe long-distance interhospital ground transfer of critically ill patients with acute severe unstable respiratory and circulatory failure.
To assess the safety of long-distance ground interhospital transport of critically ill patients with the most severe unstable respiratory failure after establishment of a dedicated transport system. ⋯ Long-distance interhospital ground transfer of even critically ill patients with severe unstable respiratory and circulatory failure is safe if a dedicated transport team and a specially equipped transport vehicle are used.
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Intensive care medicine · Aug 2002
Comparative StudyExogenous surfactant reduces ventilator-induced decompartmentalization of tumor necrosis factor alpha in absence of positive end-expiratory pressure.
To determine the effect of pretreatment with exogenous surfactant on ventilator-induced decompartmentalization of TNF-alpha. ⋯ An excess of active surfactant decreases transfer of cytokines across the alveolar-capillary membrane similar to PEEP. The combination of PEEP and surfactant reduces decompartmentalization of TNF-alpha even further.
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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.