Intensive care medicine
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Intensive care medicine · Aug 2010
Randomized Controlled Trial Multicenter StudyGastric residual volume during enteral nutrition in ICU patients: the REGANE study.
To compare the effects of increasing the limit for gastric residual volume (GRV) in the adequacy of enteral nutrition. Frequency of gastrointestinal complications and outcome variables were secondary goals. ⋯ Diet volume ratio of mechanically ventilated patients treated with enteral nutrition is not affected by increasing the limit in GRV. A limit of 500 ml is not associated with adverse effects in gastrointestinal complications or in outcome variables. A value of 500 ml can be equally recommended as a normal limit for GRV.
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Intensive care medicine · Aug 2010
Hormonal status and ICU-acquired paresis in critically ill patients.
The pathogenesis of intensive care unit-acquired paresis (ICUAP), a frequent and severe complication of critical illness, is poorly understood. Since ICUAP has been associated with female gender in some studies, we hypothesized that hormonal dysfunction might contribute to ICUAP. ⋯ ICUAP 7 days after awakening was associated with increased blood glucose and with biological evidence of hypogonadism in men, while an association with hormonal dysfunction was not detected in women.
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Intensive care medicine · Aug 2010
Goal-directed therapy in high-risk surgical patients: a 15-year follow-up study.
Goal-directed therapy in the perioperative setting has been shown to be associated with short-term improvements in outcome. This study assesses the longer-term survival of patients from a previous randomized controlled trial of goal-directed therapy in high-risk surgical patients. ⋯ Long-term survival after major surgery is related to a number of factors, including patient age and avoidance of perioperative complications. Short-term goal-directed therapy in the perioperative period may improve long-term outcomes, in part due to its ability to reduce the number of perioperative complications.
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Intensive care medicine · Aug 2010
Measuring efficiency in Australian and New Zealand paediatric intensive care units.
To develop a measure of paediatric intensive care unit (PICU) efficiency and compare the efficiency of PICUs in Australia and New Zealand. ⋯ There is significant variation in efficiency among PICUs in Australia and New Zealand. Two units were designated as inefficient and one unit was considered to be effective at the expense of high resource use. Application of these methods may help to identify inefficiencies in units located in other countries or regions.
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Intensive care medicine · Aug 2010
Effects of preserved spontaneous breathing activity during mechanical ventilation in experimental intra-abdominal hypertension.
Ventilation problems are common in critically ill patients with intra-abdominal hypertension. The aim of this study was to investigate the effects of preserved spontaneous breathing during mechanical ventilation on hemodynamics, gas exchange, respiratory function and lung injury in experimental intra-abdominal hypertension. ⋯ In the presence of severe intra-abdominal hypertension, the addition of unsupported spontaneous breaths to BIPAP did not improve hemodynamic and respiratory function and caused greater histopathologic damage to the lungs.