Intensive care medicine
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Intensive care medicine · Nov 1999
Multicenter StudyEffects of prone position on alveolar recruitment and oxygenation in acute lung injury.
To investigate the effects of prone position (PP) on alveolar recruitment and oxygenation in acute respiratory failure. ⋯ Alveolar recruitment may be a mechanism of oxygenation improvement in some patients with acute hypoxemic respiratory failure. No correlation was found between change in oxygenation and chest wall elastic properties.
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Intensive care medicine · Nov 1999
Randomized Controlled Trial Clinical TrialBronchodilator delivery by metered-dose inhaler in mechanically ventilated COPD patients: influence of tidal volume.
The delivery of bronchodilator drugs with metered-dose inhaler (MDI) and a spacer in mechanically ventilated patients has become a widespread practice. However, the various ventilator settings that influence the efficacy of MDI are not well established. The tidal volume (VT) during drug delivery has been suggested as one of the factors that might increase the effectiveness of this therapy. To test this, the effect of two different VT on the bronchodilation induced by beta 2-agonists administered with MDI and a spacer in a group of mechanically ventilated patients with chronic obstructive pulmonary disease (COPD) was examined. ⋯ We conclude that S delivered with an MDI and a spacer device induces significant bronchodilation in mechanically ventilated patients with COPD, the magnitude of which is not affected by at least a 50% increase in VT. These results do not support the VT manipulations when bronchodilators are administered in adequate doses during controlled mechanical ventilation.
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Intensive care medicine · Nov 1999
Clinical Trial Controlled Clinical TrialThe use of different buffers during continuous hemofiltration in critically ill patients with acute renal failure.
To determine the impact of different hemofiltration (HF) replacement fluids on the acid-base status and cardiovascular hemodynamics in patients with acute renal failure (ARF) and continuous veno-venous hemofiltration (CVVH). ⋯ The degree of correction of acidosis during hemofiltration was determined by patient outcome in patients treated with lactate- and bicarbonate-based buffer solutions, but not in patients receiving acetate-buffered solution. Bicarbonate and lactate-based buffer solutions were found to be superior to acetate-based replacement fluid.
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To determine the time to onset of the adult respiratory distress syndrome (ARDS) in patients with thermal injury requiring mechanical ventilation. Secondarily, to consider the burn-related risk factors, demographics, incidence, and mortality for ARDS in this population. ⋯ According to the American-European Consensus Conference and the Lung Injury Severity Score definitions, ARDS is common in the adult burn population and has a delayed onset compared to most critical care populations. We found age to be a major predisposing factor for ARDS.
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Intensive care medicine · Nov 1999
Clinical TrialIntravenous nicardipine for severe hypertension in pre-eclampsia--effects of an acute treatment on mother and foetus.
To assess the efficacy in lowering blood pressure, and the safety for mother and foetus of an acute nicardipine therapy in severe pre-eclampsia. ⋯ Acute nicardipine therapy can induce severe maternal tachycardia. No severe foetal or neonatal adverse effects occurred. This dose scheme requires comparison with alternative therapeutic options.