Intensive care medicine
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Intensive care medicine · Mar 2003
Hypothermia protects against endotoxin-induced acute lung injury in rats.
Hypothermia in humans and animals is known to decrease the number and function of circulating neutrophils. Because an activation of circulating neutrophils and their sequestration into the lung are important pathogenetic phenomena in endotoxin-associated lung injury, we conjectured that hypothermia could prevent this type of lung injury. ⋯ Hypothermia pretreatment decreased the pulmonary sequestration of neutrophils, induced a favorable balance between pro- and anti-inflammatory cytokines, and attenuated histologic injury in endotoxin-challenged rats.
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Intensive care medicine · Mar 2003
ReviewFluid responsiveness in mechanically ventilated patients: a review of indices used in intensive care.
In mechanically ventilated patients the indices which assess preload are used with increasing frequency to predict the hemodynamic response to volume expansion. We discuss the clinical utility and accuracy of some indices which were tested as bedside indicators of preload reserve and fluid responsiveness in hypotensive patients under positive pressure ventilation. ⋯ Although preload assessment can be obtained with fair accuracy, the clinical utility of volume responsiveness-guided fluid therapy still needs to be demonstrated. Indeed, it is still not clear whether any form of monitoring-guided fluid therapy improves survival.
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Intensive care medicine · Mar 2003
Randomized Controlled Trial Clinical TrialInfluence of tidal volume on left ventricular stroke volume variation measured by pulse contour analysis in mechanically ventilated patients.
Real-time measurement of stroke volume variation by arterial pulse contour analysis (SVV) is useful in predicting volume responsiveness and monitoring volume therapy in mechanically ventilated patients. This study investigated the influence of the depth of tidal volume (V(t)) on SVV both during the state of fluid responsiveness and after fluid loading in mechanically ventilated patients. ⋯ In addition to intravascular volume status SVV is affected by the depth of tidal volume under mechanical ventilation. This influence must be regarded when using SVV for functional preload monitoring.
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Intensive care medicine · Mar 2003
Comparative StudyTemperature measurement in intensive care patients: comparison of urinary bladder, oesophageal, rectal, axillary, and inguinal methods versus pulmonary artery core method.
Comparisons of urinary bladder, oesophageal, rectal, axillary, and inguinal temperatures versus pulmonary artery temperature. ⋯ In critically ill patients, urinary bladder and oesophageal electronic thermometers are more reliable than the electronic rectal thermometer which is better than inguinal and axillary gallium-in-glass thermometers to measure core temperature.