Intensive care medicine
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Intensive care medicine · Dec 2002
Ability and safety of a heated humidifier to control hypercapnic acidosis in severe ARDS.
To assess the ability of a heated humidifier to improve CO(2) clearance in ARDS patients submitted to protective ventilation. ⋯ Supposing there is an interest in correcting or limiting hypercapnic acidosis in ARDS patients submitted to protective ventilation, HME removal and use of HH appears to be an efficient and safe way of increasing CO(2) clearance.
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Intensive care medicine · Dec 2002
Randomized Controlled Trial Comparative Study Clinical TrialNoninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial.
We conducted a randomized prospective study comparing noninvasive positive pressure ventilation (NPPV) with conventional mechanical ventilation via endotracheal intubation (ETI) in a group of patients with chronic obstructive pulmonary disease who failed standard medical treatment in the emergency ward after initial improvement and met predetermined criteria for ventilatory support. ⋯ The use of NPPV in patients with chronic obstructive pulmonary disease and acute respiratory failure requiring ventilatory support after failure of medical treatment avoided ETI in 48% of the patients, had the same ICU mortality as conventional treatment and, at 1-year follow-up was associated with fewer patients readmitted to the hospital or requiring for long-term oxygen supplementation. An editorial regarding this article can be found in the same issue (http://dx.doi.org/10.1007/s00134-002-1503-3).
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Intensive care medicine · Dec 2002
Clinical TrialProgression rate of self-propelled feeding tubes in critically ill patients.
Gaining postpyloric access in ventilated, sedated ICU patients usually requires time-consuming procedures such as endoscopy. Recently, a feeding tube has been introduced that migrates spontaneously into the jejunum in surgical patients. The study aimed at assessing the rate of migration of this tube in critically ill patients. ⋯ Self-propelled feeding tubes progressed from the stomach to the postpyloric position in 49% of patients, reducing the number of endoscopic placements: these tubes may facilitate enteral nutrient delivery in the ICU.