Intensive care medicine
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Intensive care medicine · May 1999
Case ReportsSevere accidental hypothermia: rewarming strategy using a veno-venous bypass system and a convective air warmer.
To study a rewarming strategy for patients with severe accidental hypothermia using a simple veno-venous bypass in combination with a convective air warmer. ⋯ This rewarming technique seems safe and effective and allowed the controlled rewarming of our patients who suffered from severe accidental hypothermia
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Intensive care medicine · May 1999
Comparative StudyEarly SjvO2 monitoring in patients with severe brain trauma.
To investigate early cerebral variables after minimal resuscitation and to compare the adequacy of a cerebral perfusion pressure (CPP) guideline above 70 mmHg, with jugular bulb venous oxygen saturation (SjvO2) monitoring in a patient with traumatic brain injury (TBI). ⋯ The present study shows that early cerebral monitoring with SjvO2 is critical to assess cerebral ischemic risk and that MAP monitoring alone is not sensitive enough to determine the state of oxygenation of the brain. SjvO2 monitoring permits the early identification of patients with low CPP and high risk of cerebral ischemia. In emergency situations it can be used alone when ICP monitoring is contraindicated or not readily available. However, ICP monitoring gives complementary information necessary to adapt treatment.
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Intensive care medicine · May 1999
Noninvasive ventilation: experience at a community teaching hospital.
To describe our hospital's experience with noninvasive positive pressure ventilation (bilevel positive airway pressure; BiPAP) for patients with respiratory failure (RF). ⋯ BiPAP is highly effective in selected patients with RF during routine use in a community teaching hospital. The success rate is higher amongst patients presenting with hypercapnic than amongst those with hypoxemic RF and BiPAP failure is associated with an increased likelihood of in-hospital mortality. BiPAP may also be used successfully to temporize patients who develop RF in the period following endotracheal extubation. The duration of BiPAP dependency (35 h in this study) was shorter than in previous trials, and, though this is speculative, may have been minimized by our performing a trial of unassisted breathing each day.
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Intensive care medicine · May 1999
Mechanical ventilation of patients on long-term oxygen therapy with acute exacerbations of chronic obstructive pulmonary disease: prognosis and cost-utility analysis.
To analyze the prognosis and costs of mechanical ventilation in patients with exacerbations of chronic obstructive pulmonary disease (COPD) treated with long-term oxygen therapy. ⋯ Applying mechanical ventilation to COPD patients treated with long-term oxygen therapy carries a high mortality and cost. Factors significantly associated with mortality in the ICU were albumin and sodium concentrations and FEV1 in hospital and in the first year after discharge.