Intensive care medicine
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Intensive care medicine · Nov 2006
Multicenter StudyIncreased colorectal permeability in patients with severe sepsis and septic shock.
To develop a method for the assessment of colorectal permeability in septic patients. ⋯ In septic patients, the systemic recovery of a luminally applied marker of paracellular permeability was increased and related to the luminal concentrations of L-lactate and possibly to disease severity. This suggests that the assessment of colorectal permeability by systemic recovery of (99m)Tc-DTPA is valid and that metabolic dysfunction of the mucosa contributes to increased permeability of the large bowel in patients with severe sepsis and septic shock.
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Intensive care medicine · Nov 2006
Randomized Controlled Trial Multicenter Study Comparative StudyVasopressin or norepinephrine in early hyperdynamic septic shock: a randomized clinical trial.
To compare the effects of arginine-vasopressin (AVP) and norepinephrine (NE) on hemodynamic variables, organ dysfunction, and adverse events in early hyperdynamic septic shock. ⋯ In early hyperdynamic septic shock, the administration of high-dose AVP as a single agent fails to increase mean arterial pressure in the first hour but maintains it above 70mmHg in two-thirds of patients at 48h. AVP decreases NE exposure, has no effect on the PrCO(2) - PaCO(2 )difference, and improves renal function and SOFA score.
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Intensive care medicine · Nov 2006
Multicenter Study Comparative StudyBenefits and risks of success or failure of noninvasive ventilation.
Noninvasive ventilation (NIV) fails more frequently for de novo acute respiratory failure (de novo) than for cardiogenic pulmonary edema (CPE) or acute-on-chronic respiratory failure (AOC). The impact of NIV failure and success was compared between de novo and CPE or AOC after adjustment for disease severity. ⋯ The effect of NIV differs between de novo and CPE-AOC patients because NIV failure is associated with increased mortality for de novo patients. This finding should raise a note of caution when applying NIV in this indication.
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Intensive care medicine · Nov 2006
Multicenter StudyIncreased use of noninvasive ventilation in French intensive care units.
A prospective survey of French intensive care units (ICUs) in 1997 showed moderate and variable use of noninvasive ventilation (NIV). This study examined changes in NIV use in French ICUs after the intervening 5years. ⋯ NIV use has significantly increased in French ICUs during the past 5years, and the success rate has remained unchanged. In patients not previously intubated, NIV is the leading first-line ventilation modality. The proportion of patients successfully treated with NIV increased significantly over the 5-year period (13% vs. 9% of all patients receiving ventilatory support).
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Intensive care medicine · Nov 2006
Multicenter StudyPredictors of early recovery of health status after intensive care.
To identify factors predictive of good or poor recovery of health status and health-related quality of life (HRQOL) 90 days after admission to an intensive care unit (ICU). ⋯ More than 60% of ICU patients report good recovery of their health 90 days after ICU admission, depending on their illness and circumstances of ICU admission.