Intensive care medicine
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Intensive care medicine · Aug 2001
Comparative StudyPlasma levels of macrophage migration inhibitory factor are elevated in patients with severe sepsis.
To investigate the role of macrophage migration inhibitory factor (MIF) as a marker of severity of systemic inflammation in patients with severe sepsis and critically ill postsurgical patients. ⋯ MIF serves as a general marker for systemic inflammation in septic and nonseptic acute critical illness, but MIF does not discriminate for severity or differentiate between infectious and noninfectious origins of an acute critical illness.
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(1) To establish risk factors for the development of delirium in an intensive care unit (ICU) and (2) to determine the effect of delirium on morbidity, mortality and length of stay. ⋯ Predictive risk factors for the development of delirium in studies outside the ICU may not be applicable to critically ill patients. Delirium is associated with increased morbidity. Awareness of patients at risk may lead to better recognition and earlier intervention.
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Intensive care medicine · Aug 2001
Decision-making capacity and surrogate designation in French ICU patients.
To evaluate the capacity and willingness of French-speaking patients to designate a surrogate within 24 h of their ICU admission. French laws fail to indicate what should be done when an otherwise legally competent patient transiently loses his decision-making capacity. ⋯ Surrogate designation by a patient should be evaluated in the light of the decision-making capacity of the patient. The traditional French paternalism still practiced by many French physicians appears out of tune with the wishes of their patients. We suggest that there is a need for developing a simple and effective tool for assessing decision-making capacity in ICU patients.
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Intensive care medicine · Aug 2001
Continuous on-line measurements of respiratory system, lung and chest wall mechanics during mechanic ventilation.
We present a concept of on-line, manoeuvre-free monitoring of respiratory mechanics during dynamic conditions, displaying calculated alveolar pressure/volume curves continuously and separating lung and chest wall mechanics. ⋯ The monitoring concept revealed a constant pattern of successively decreasing compliance within each breath, which became more prominent with increasing PEEP and tidal volume. The monitoring concept offers a simple and reliable method of monitoring respiratory mechanics during ongoing ventilator treatment.
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Intensive care medicine · Aug 2001
Time-dependency of sensory evoked potentials in comatose cardiac arrest survivors.
To assess the validity of early sensory evoked potential (SEP) recording for reliable outcome prediction in comatose cardiac arrest survivors within 48 h after restoration of spontaneous circulation (ROSC). ⋯ Within 24 h after ROSC there was a significant improvement in SEP. Therefore we recommend allowing a period of at least 24 h after cardiopulmonary resuscitation for obtaining a reliable prognosis based on SEP.