Intensive care medicine
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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.
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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
Comparative StudyEffect of the degree of tricuspid regurgitation on cardiac output measurements by thermodilution.
To determine the relationship between the degree of tricuspid regurgitation (TR) and accuracy of cardiac output measurement by thermodilution in mechanically ventilated patients. DESIGN AND SETTING. Prospective observational study in a 20-bed general intensive care unit in the university hospital. ⋯ A high degree of TR is associated with underestimation of cardiac output measured by thermodilution.
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Intensive care medicine · Aug 2002
Comparative StudyDead-space reduction and tracheal pressure measurements using a coaxial inner tube in an endotracheal tube.
To evaluate the effects on CO(2) washout of the coaxial double lumen tube (DLT) as compared to a standard endotracheal tube (ETT) and tracheal gas insufflation (TGI). Precision of tracheal pressure monitoring through the DLT and safety issues, including intrinsic PEEP (PEEPi) formation during DLT ventilation, were also evaluated. ⋯ The double lumen tube is as effective as tracheal gas insufflation in reducing CO(2) tension. Tracheal pressure and formation of PEEPi can be monitored with high precision without interrupting ventilation.
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Intensive care medicine · Aug 2002
Comparative Study Clinical TrialEarly increase of procalcitonin after cardiovascular surgery in patients with postoperative complications.
Type and frequency of postoperative abnormalities were registered after cardiovascular surgery to evaluate the aetiology and diagnostic value of increased concentrations of procalcitonin (PCT) and C-reactive protein (CRP) during the early postoperative period. ⋯ Elevated PCT, but not CRP, correlates with evidence of systemic inflammation and other complications early postoperatively after cardiac surgery. Although the PCT levels do not rise as quickly as the criteria of the systemic inflammatory response syndrome appear, they do reflect systemic inflammation. Early identification and quantification of a systemic inflammatory response may help reduce postoperative complications.