Intensive care medicine
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Intensive care medicine · Sep 1999
Comparative StudyFeasibility and safety of ultrasound-aided thoracentesis in mechanically ventilated patients.
Thoracentesis in a ventilated patient is rarely performed because of the risk of pneumothorax. We have evaluated the safety of this procedure when aided by ultrasound. ⋯ If basic rules are followed, ultrasound localization makes thoracentesis a safe, easy and simple procedure in patients on mechanical ventilation.
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Intensive care medicine · Sep 1999
Comparative StudyApplication of mortality prediction systems to individual intensive care units.
To evaluate the predictive accuracy of the severity of illness scoring systems in a single institution. ⋯ Although the overall mortality was consistent with the predicted mortality, the poor fit of the data to the model impairs the validity of the result. The observed outcome could be due to erratic quality of care, or differences between the study population and the patient population in the original studies. The data cannot be used to distinguish between these possibilities. To increase predictive accuracy when studying individual intensive care units and enhance quality of care assessments it may be necessary to adapt the model to the patient population.
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To evaluate resting energy expenditure (REE) in brain dead patients and to investigate the hypothesis that the reduction in REE results from a decrease in cerebral blood flow. ⋯ In brain dead patients, REE decreases to values lower than BMR. This can be attributed to the cessation of cerebral blood flow and consequently cerebral metabolism and not to hypothermia.
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Intensive care medicine · Aug 1999
Comparative Study Clinical Trial Controlled Clinical TrialProportional assist versus pressure support ventilation: effects on breathing pattern and respiratory work of patients with chronic obstructive pulmonary disease.
To investigate the breathing pattern and the inspiratory work of breathing (WOB(I)) in patients with chronic obstructive pulmonary disease (COPD) assisted with proportional assist ventilation (PAV) and conventional pressure support ventilation (PSV). ⋯ Mean values of breathing pattern did not differ by a large amount between the investigated modes. However, the higher variability of V(T) during PAV indicates an increased ability of the patients to control V(T) in response to alterations in respiratory demand. A reduction in assist during PAV(50) resulted in an increase in WOB and indices of patient effort.
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Intensive care medicine · Aug 1999
Comparative Study Clinical TrialComparison of pulmonary artery and arterial thermodilution cardiac output in critically ill patients.
We studied the agreement between cardiac output measurements via pulmonary artery thermodilution [CO(PA)], regarded as the current clinical gold standard, and aortic transpulmonary thermodilution [CO(AORTA)]. ⋯ Cardiac output derived from aortic transpulmonary thermodilution is suitable for measurement in the intensive care unit. Measurements of CO(AORTA) are consistent with, but slightly higher than, those obtained from pulmonary artery thermodilution.