Intensive care medicine
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Intensive care medicine · May 2000
Case ReportsDialysis disequilibrium syndrome: an unusual cause of respiratory failure in the medical intensive care unit.
We describe a case of the dialysis disequilibrium syndrome (DDS) that was marked by the rapid onset of cerebral edema and the subsequent development of acute respiratory failure. The patient was treated successfully with a combination of mechanical hyperventilation and mannitol. The clinical presentation, pathogenesis, prevention and treatment of the entity are discussed.
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Intensive care medicine · May 2000
Comparative StudyAccuracy and reproducibility of long-term implanted transit-time ultrasound flow probes in dogs.
To assess the accuracy and reproducibility of long-term implanted ultrasound transit-time flow probes for measuring cardiac output. ⋯ After in vivo calibration, ultrasound transit-time flow probes measure cardiac output precisely for several years, regardless of the intervention.
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Intensive care medicine · May 2000
Acute renal failure following cardiopulmonary bypass: a changing picture.
To assess the incidence of acute renal failure (ARF) developing perioperatively in adult patients requiring cardiopulmonary bypass surgery (CPB) and to make comparisons with data from the same institution published earlier. ⋯ The need for CVVH following CPB may be diminishing despite increased risk factors. ARF-associated mortality in these circumstances is falling.
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To evaluate the risk and effectiveness of pericardiocentesis in primary and repeat cardiac tamponade. ⋯ Pericardiocentesis is the treatment of choice for primary symptomatic pericardial effusion. In recurrent pericardial effusion surgical approaches appear to be preferable.
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Intensive care medicine · May 2000
Multicenter Study Clinical TrialThe impact of respiratory variables on mortality in non-ARDS and ARDS patients requiring mechanical ventilation.
Primarily, to determine if respiratory variables, assessed on a daily basis on days 1-6 after ICU admission, were associated with mortality in non-ARDS and ARDS patients with respiratory failure requiring mechanical ventilation. Secondarily, to determine non-respiratory factors associated with mortality in ARDS and non-ARDS patients. ⋯ No independent significant association was seen between 90-day mortality and degree of hypoxaemia, PEEP, MAP or BE for the first full week of ICU care in either ARDS or non-ARDS. In a sub-group of non-ARDS a lower PaO2/FIO2 and MAP tended to influence mortality where a significant association was seen for 3 of 7 study days. Age, gender, APS, presence of a chronic disease and a pulmonary/non-pulmonary reason for the respiratory failure were associated with mortality in non-ARDS, while only age and APS showed a similar association in ARDS.