Intensive care medicine
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Intensive care medicine · Oct 2000
Comparative StudyCardiac output measured by lithium dilution and transpulmonary thermodilution in patients in a paediatric intensive care unit.
To compare the results of cardiac output measurements obtained by lithium dilution and transpulmonary thermodilution in paediatric patients. ⋯ These results suggest that the LiDCO method can be used to provide safe and accurate measurement of cardiac output in paediatric patients. The method is simple and quick to perform, requiring only arterial and venous catheters, which will already have been inserted for other reasons in these patients.
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Intensive care medicine · Oct 2000
Out-of-hospital diagnosis of cerebral infarction versus intracranial hemorrhage.
To establish a model based on clinical and anamnestic data easily available in the out-of-hospital setting, which facilitates the differential diagnosis between cerebral infarction and intracranial hemorrhage. ⋯ Our model is a useful guideline for the differential diagnosis between cerebral infarction and intracranial hemorrhage in the out-of-hospital setting, as it is based on easily available clinical and anamnestic parameters.
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Intensive care medicine · Oct 2000
Esophageal motility disorders in critically ill patients: a 24-hour manometric study.
Impaired tubular esophageal motility is involved in the pathogenesis of gastroesophageal reflux disease, which, in turn, has been shown to cause nosocomial pneumonia in critically ill patients. As multiple factors are involved, this pilot study was undertaken to evaluate whether, similarly, impaired esophageal motility may contribute to nosocomial infections by determining esophageal motility in critically ill patients undergoing mechanical ventilation and sedation in comparison to that of a healthy control group. ⋯ Irrespective of the underlying disease, propulsive motility of the esophageal body is significantly reduced during any kind of sedation in critically ill patients. Possibly central as well peripheral drug-related effects are involved in such a depression. Twenty-four hour motility recordings appear to be a valuable and feasible method to quantify and analyze esophageal motor disorders in critically ill patients.
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Intensive care medicine · Oct 2000
Do we need new indications for ECMO in neonates pretreated with high-frequency ventilation and/or inhaled nitric oxide?
High-frequency ventilation (HFV) and/or inhaled nitric oxide (iNO) has reduced ECMO in neonates. But, frequently, improvement with HFV/iNO is temporary and only prolongs lung injury without preventing ECMO. We tried to identify a threshold oxygenation index (OI) that predicts temporary or persistent improvement with HFV/iNO in neonatal ECMO candidates as early as possible. ⋯ For neonates pretreated with HFV/iNO, an OI > 40 is an inadequate ECMO indication. Based on our data we hypothesize that an OI > or = 25 after 72 h of HFV/ iNO is a better ECMO indication that avoids prolonged barotrauma.
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Intensive care medicine · Oct 2000
Prevalence of tracheostomy in ICU patients. A nation-wide survey in Switzerland.
To assess the frequency, timing and technique of tracheostomy and its variation between different intensive care units (ICUs) in Switzerland. ⋯ Despite its frequency, tracheostomy in Swiss ICUs is far from being standardized with regard to indication, timing and choice of technique.