Intensive care medicine
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Critical care physicians are frequently confronted with intoxicated patients who have used street drugs. In the last decade there has been an upward trend in the use of these substances, particularly amongst adolescents and young adults in large urban areas. ⋯ Early and appropriate medical attention by emergency medicine physicians and intensivists can improve outcomes. In this review article we intend to familiarize critical care physicians with the most common street drugs such as amphetamines, ecstasy, cocaine, gamma hydroxybutyrate, opioids, and phencyclidine.
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Intensive care medicine · Aug 2004
Comparative StudyPsychiatric outcome following paediatric intensive care unit (PICU) admission: a cohort study.
To determine whether paediatric intensive care unit (PICU) admission is associated with greater psychiatric morbidity in children and parents as compared with general paediatric ward admissions. ⋯ Post traumatic stress disorder diagnosis and symptomatology is significantly more common in families where a child has been admitted to the PICU. Consideration should be given to providing psychological support for children and parents after PICU admission.
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Intensive care medicine · Aug 2004
Perspectives for core and skin surface temperature guided extubation in patients after normothermic cardiopulmonary bypass.
To investigate the relationship between changes in core and skin surface temperature and extubation time in patients following normothermic cardiopulmonary bypass (CPB). ⋯ This study demonstrates that the transition period from peripheral vasoconstriction to vasodilation provides an opportunity for postoperative extubation.
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Intensive care medicine · Aug 2004
Comparative StudyEffectiveness and side effects of closed and open suctioning: an experimental evaluation.
To compare the effectiveness of closed system suctioning (CSS) and open system suctioning (OSS) and the side effects on gas exchange and haemodynamics, during pressure-controlled ventilation (PCV) or continuous positive airway pressure (CPAP). ⋯ Irrespective of catheter size, OSS and CSS during CPAP 0 cmH(2)O were markedly more effective than CSS during PCV and CPAP 10 cmH(2)O but had worse side effects. However, the side effects lasted less than 5 min in this animal model. Suctioning should be performed effectively when absolutely indicated and the side effects handled adequately.
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To describe the incidence of the catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) of central venous catheters (CVCs) and arterial catheters (ACs). ⋯ In the CDC guidelines, catheter insertion at the subclavian site is recommended in preference to femoral and jugular accesses, and there is no recommendation about AC site insertion. Our data support these recommendations about CVCs. Because the AC infection rate was very low, our study suggests that the access site is probably not of major importance for this type of catheter.