Intensive care medicine
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Intensive care medicine · Jul 1999
Sensitivity and specificity of a screening test to document traumatic experiences and to diagnose post-traumatic stress disorder in ARDS patients after intensive care treatment.
Many survivors of critical illness and intensive care unit (ICU) treatment have traumatic memories such as nightmares, panic or pain which can be associated with the development of posttraumatic stress disorder (PTSD). In order to simplify the rapid and early detection of PTSD in such patients, we modified an existing questionnaire for diagnosis of PTSD and validated the instrument in a cohort of ARDS patients after long-term ICU therapy. ⋯ The questionnaire was found to be a responsive, valid and reliable instrument to screen survivors of intensive care for PTSD.
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Intensive care medicine · Jul 1999
The aetiology and pathogenesis of cardiopulmonary bypass-associated metabolic acidosis using polygeline pump prime.
The pathogenesis of the metabolic acidosis of cardiopulmonary bypass (CPB) is not fully understood. New quantitative methods of acid-base balance now make it possible to describe it more clearly. Accordingly, we studied acid-base changes during CPB with polygeline pump prime and defined and quantified the factors which contribute to metabolic acidosis. ⋯ Using quantitative biophysical methods, it can be demonstrated that, in patients receiving a pump prime rich in chloride and polygeline, the metabolic acidosis of CPB is mostly due to iatrogenic increases in serum chloride concentration and unmeasured strong anions (SIG). Its development is partially attenuated by iatrogenic hypoalbuminaemia. Changes in lactate concentrations did not play a role in the development of metabolic acidosis in our patients.
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Intensive care medicine · Jul 1999
Comparative StudyComparison of different methods for dead space measurements in ventilated newborns using CO2-volume plot.
The aim of the study was to test the applicability of Ventrak 1550/Capnogard 1265 (V-C) for respiratory dead space (VD) measurement and to determine anatomic (VDana), physiologic (VDphys), and alveolar dead spaces (VDalv) in ventilated neonates. ⋯ In ventilated newborns, dead space measurements were possible only in one-third by SBT-CO2, but in all cases by Bohr/Enghoff equations. Improved software could further reduce the time needed for one analysis.
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Intensive care medicine · Jul 1999
Aspiration of dead space allows normocapnic ventilation at low tidal volumes in man.
Aspiration of dead space (ASPIDS) improves carbon dioxide (CO2) elimination by replacing dead space air rich in CO2 with fresh gas during expiration. The hypothesis was that ASPIDS allows normocapnia to be maintained at low tidal volumes (VT). ⋯ The results of this study suggest that ASPIDS may be a useful and safe modality of mechanical ventilation that limits alveolar pressure and minute ventilation requirements while keeping PaCO2 constant.
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Intensive care medicine · Jul 1999
Severe brain injury in children: long-term outcome and its prediction using somatosensory evoked potentials (SEPs).
To evaluate the outcome of children 1 and 5 years after severe brain injury (Glasgow Coma Score < 8) using a functional measure [Glasgow Outcome Scale (GOS)] and a health status measure (the Torrance Health State (HUI:1)) and to determine the ability of somatosensory evoked potentials (SEPs) to predict these long-term outcomes. ⋯ The outcome for children with severe brain injury should be assessed 5 years after injury because important changes occur between 1 year and 5 years. Differences exist between outcomes assessed using the GOS and HUI:1 as they measure slightly different aspects of function. Consideration should therefore be given to using both measures. SEPs are excellent predictors of long-term outcome measured by either the GOS or the HUI:1.