Intensive care medicine
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Intensive care medicine · Jun 2000
Relationship between intracranial pressure, mild hypothermia and temperature-corrected PaCO2 in patients with traumatic brain injury.
To study the effects of mild hypothermia and associated changes in temperature-corrected PaCO2 (cPaCO2) on intracranial pressure (ICP), mean velocity of the middle cerebral artery (Vm), and venous jugular saturation in O2 (SjvO2) in patients with severe traumatic brain injury (TBI). ⋯ The decrease in ICP was similar when hypocapnia was induced by hyperventilation or as a result of hypothermia alone. The relationship between cPaCO2 and ICP might predict variations in ICP during changes in core temperature. Further studies are needed to confirm the cerebral metabolic effects of moderate hypothermia in TBI patients.
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Intensive care medicine · Jun 2000
The effect of lung injury and excessive lung fluid, on impedance cardiac output measurements, in the critically ill.
To investigate the relationship between the attenuation of impedance cardiac output (IC(co)) measurements and lung fluid content in critically ill patients. ⋯ The BoMed under-estimates cardiac output in critically ill patients. In septic patients the degree of attenuation of IC(co) can be related to the extent of lung injury and fluid accumulation within the thorax.
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Intensive care medicine · Jun 2000
Evaluation of a new module in the continuous monitoring of respiratory mechanics.
Bedside monitoring of respiratory mechanics facilitates the use of lung protective ventilation in acute lung injury (ALI). We evaluated a new clinical monitor of respiratory mechanics. ⋯ The waveform data of the new monitor is accurate. The value of the automatically derived variables is limited by the fact that inspiratory plateau pressure and plateau compliance have no direct physiological meaning. Nevertheless, in clinical monitoring much information can be derived from the waveform signals alone and from pressure-volume and flow-volume loops. These facilitate monitoring changes in respiratory mechanics in the ALI patient.
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Intensive care medicine · Jun 2000
Roundtable conference on tissue oxygenation in acute medicine, Brussels, Belgium, 14-16 March 1998.
* Nutritional tissue perfusion and tissue metabolic demand are heterogeneously distributed. * Oxygen diffusion occurs preferentially at the precapillary arteriolar level. * Determination of adequacy of tissue oxygenation requires local organ measurements. * While there remains considerable variability in individual RBC transfusion practices, a recent clinical trial questioned the efficacy of RBC transfusion to hemoglobin concentrations greater than 80 gm/l in patients without heart disease [63]. * RBC substitutes, including cell-free hemoglobin solutions and PFC solutions are efficacious, yet may exhibit a number of direct vascular effects.
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Intensive care medicine · Jun 2000
Editorial CommentRespiratory mechanics in ARDS: a siren for physicians?