Intensive care medicine
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Intensive care medicine · Jan 2003
Outcome of children with different accessibility to tertiary pediatric intensive care in a developing country--a prospective cohort study.
Lack of direct access to tertiary pediatric intensive care services in rural hospitals may be associated with poorer outcome among critically ill children. Inter-hospital transport by non-specialized teams may also lead to increased morbidity and even mortality. We therefore studied the outcome of children with different accessibility to tertiary pediatric care in Malaysia. ⋯ The outcome of critically ill children transferred from community hospitals did not differ from that of those who develop ICU needs in the wards of a tertiary center, despite being transported by non-specialized teams. Outcome was not affected by initial inaccessibility to intensive care if the children finally received care in a tertiary center.
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Intensive care medicine · Jan 2003
Effect of end-inspiratory pause duration on plateau pressure in mechanically ventilated patients.
To compare the values of plateau pressure (Pplat) recorded at different times after end-inspiratory occlusion and those of static elastance (Est,rs) and total resistance (Rrs) of the respiratory system. ⋯ Very early post-occlusion values of Pplat were statistically greater than at 3 s or 5 s. This probably has no major impact on the occurrence of volutrauma. Clinicians must be aware, however, that Est,rs and Rrs are greatly modified by the time of recording of Pplat.
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Intensive care medicine · Jan 2003
Post-extubation stridor in intensive care unit patients. Risk factors evaluation and importance of the cuff-leak test.
To evaluate the incidence and identify factors associated with the occurrence of post-extubation stridor and to evaluate the performance of the cuff-leak test in detecting this complication. ⋯ A low cuff-leak volume (<130 ml or 12%) around the endotracheal tube prior to extubation is useful in identifying patients at risk for post-extubation stridor.
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Intensive care medicine · Jan 2003
Neutropenia and the development of the systemic inflammatory response syndrome.
To determine outcome and natural course of systemic inflammatory response syndrome (SIRS) stages in adult febrile neutropenic patients. ⋯ Mortality and progression to septic shock increased as more SIRS criteria were met on admission. SIRS stages could serve as a risk-assessing model in febrile neutropenic patients.
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Intensive care medicine · Jan 2003
Effects of prolonged mechanical ventilation on respiratory muscle ultrastructure and mitochondrial respiration in rabbits.
To investigate in rabbits whether prolonged mechanical ventilation (PMV) leads to ultrastructural changes in respiratory muscles and alters diaphragm mitochondrial respiration. ⋯ PMV leads to respiratory muscle cell degeneration and minor changes in oxidative phosphorylation coupling in diaphragmatic mitochondria. These phenomena may mediate part of damage of respiratory muscles after inactivity related to PMV.