Intensive care medicine
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Intensive care medicine · Feb 2002
Airway obstruction and ventilator dependency in young children with congenital cardiac defects: a role for self-expanding metal stents.
Young children with congenital cardiac defect and airway obstruction leading to ventilator dependency present a significant clinical challenge with uncertain outcome. ⋯ Airway stenting in such young children is an infrequent procedure often undertaken in dire circumstances. We have found it valuable in enabling ventilator-dependent children to be extubated with encouraging early results. Their long-term outlook remains uncertain and is dependent on the underlying cardiac status.
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Intensive care medicine · Feb 2002
Randomized Controlled Trial Clinical TrialPhysiological effects of constant versus decelerating inflation flow in patients with chronic obstructive pulmonary disease under controlled mechanical ventilation.
To study the cardiorespiratory effects of inspiratory flow rate and waveform in COPD patients. ⋯ Changing the ventilator in volume-controlled mode with a DF or CF profile has no significant cardiorespiratory effect in intubated COPD patients mechanically ventilated for acute respiratory failure.
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Intensive care medicine · Feb 2002
Randomized Controlled Trial Comparative Study Clinical TrialImpact of sepsis, lung injury, and the role of lipid infusion on circulating prostacyclin and thromboxane A(2).
To investigate whether plasma levels of prostacyclin (PGI2) and thromboxane A(2) (TxA2) are a function of the infusion rate of soybean-based fat emulsions, severity of systemic inflammation, and pulmonary organ failure. ⋯ The quantity of prostanoids formed and their subsequent utilization are dependent on the availability of precursor linoleic acid and are probably affected by the severity of SIRS or sepsis and the existence of pulmonary organ failure, respectively. Because TxA2 might be extracted by the injured lung, rapid infusion of soybean-based fat emulsions should be avoided in patients suffering from severe pulmonary organ failure.
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Intensive care medicine · Feb 2002
Comparative StudyScoring systems in pediatric intensive care: PRISM III versus PIM.
To compare the performance of two different clinical scoring systems that were developed to assess mortality probability in pediatric intensive care. ⋯ PRISM III and PIM scores are both adequate indicators of mortality probability for heterogeneous patient groups in pediatric intensive care. Possibly in larger studies (equivalence trial) a significant and relevant difference between these scores would be demonstrated.