Intensive care medicine
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Intensive care medicine · Dec 2000
Randomized Controlled Trial Multicenter Study Clinical TrialContinuous positive airway pressure facilitates spontaneous breathing in weaning chronic obstructive pulmonary disease patients by improving breathing pattern and gas exchange.
To elucidate the effects of continuous positive airway pressure (CPAP) on breathing pattern, gas exchange and the ability to sustain spontaneous breathing (SB) in chronic obstructive pulmonary disease (COPD) patients with dynamic hyperinflation. ⋯ CPAP helps severely ill COPD patients sustain SB. Apparently it does so by promoting slower, deeper breathing and thus facilitating carbon dioxide elimination.
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Intensive care medicine · Dec 2000
Clinical Trial Controlled Clinical TrialLow flow inflation pressure-time curve in patients with acute respiratory distress syndrome.
In mechanically ventilated patients with ARDS, determination of the lower (LIP) and upper (UIP) inflection points of the static pressure-volume curve (P-V) is crucial for planning ventilatory strategies. Recently, a simple new method was proposed for measuring the P-V curve by inflating the lung with constant low flow [14]. We hypothesized that during low flow inflation LIP and UIP might be determined using the pressure-time curve (P-T) instead of P-V. ⋯ Provided that constant flow is given relatively fast, P-T accurately determines the shape of P-V, as well as the LIP and UIP. Flow delay causes a leftward shift of the initial part of P-T, masking the presence of LIP and UIP in some cases.
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Intensive care medicine · Dec 2000
Comparative StudyComparison of Sepsis-related Organ Failure Assessment (SOFA) score and CIS (cellular injury score) for scoring of severity for patients with multiple organ dysfunction syndrome (MODS).
To evaluate the usefulness of cellular injury score (CIS) and Sepsis-related Organ Failure Assessment (SOFA) score for determination of the severity of multiple organ dysfunction syndrome (MODS). ⋯ Both SOFA score and CIS sequentially reflected the severity of MODS. Furthermore, they were comparable in diagnostic value as predictors of prognosis. These findings may indicate the possibility that MODS is a summation of effects of cellular injury. In addition, sequential evaluation of both SOFA score and CIS would provide a more accurate prediction of prognosis than conventional methods.
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Intensive care medicine · Dec 2000
ReviewIntravenous amiodarone in intensive care. Time for a reappraisal?
Amiodarone is widely used in intensive care units for the treatment of a variety of arrhythmias. It is currently the drug of choice for supraventricular tachyarrhythmias in many units because of its combination of efficacy and safety. ⋯ It outlines the electrophysiology, haemodynamics, pharmacokinetics and toxicity of the drug. In particular, it examines the recent concerns regarding acute pulmonary toxicity.