Intensive care medicine
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Intensive care medicine · Feb 1999
Randomized Controlled Trial Comparative Study Clinical TrialContinuous thermodilution cardiac output: clinical validation against a reference technique of known accuracy.
To evaluate the accuracy and precision of continuous thermodilution (CCO) by using a validated bolus thermodilution (BCO) reference technique as criterion standard. ⋯ Decreased precision of CCO as compared to iced BCO may, in clinical settings, be outweighed by the advantages of automated and continuous monitoring. Under research conditions, however, iced BCO remains the method of choice.
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Intensive care medicine · Feb 1999
Multicenter StudyEpidemiological features and prognosis of severe community-acquired pneumococcal pneumonia.
To describe risk factors of severe pneumococcal community-acquired pneumonia and to study variables influencing outcome. ⋯ Few features facilitate the identification of pneumococcal CAP on ICU admission. The prognosis is mostly related to severity of illness (leukopenia, septic shock) while comorbidities do not seem to influence outcome. Sepsis-related disorders, ICU complications and adequate antimicrobial chemotherapy are the major variables affecting the outcome during an ICU stay.
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Intensive care medicine · Feb 1999
Randomized Controlled Trial Clinical TrialEffects of early enteral nutrition on intestinal permeability and the development of multiple organ failure after multiple injury.
To determine how immediate enteral nutrition (EN) affects gut permeability and the development of multiple organ failure (MOF) in multiply injured patients. ⋯ In contrast with normal volunteers, the patients started on EN later than 24 h after admission to the ICU demonstrated increased intestinal permeability on the second day after sustaining multiple injury. Also, they had a more severe form of MOF than the group placed on EN immediately upon admission. However, early EN had no influence on the length of ICU stay or the time of mechanical ventilation.
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Intensive care medicine · Feb 1999
Multicenter StudyPrognostic performance and customization of the SAPS II: results of a multicenter Austrian study. Simplified Acute Physiology Score.
To evaluate the prognostic performance of the original Simplified Acute Physiology Score (SAPS) II in Austrian intensive care patients and to evaluate the impact of customization. ⋯ SAPS II was not well calibrated when applied to all patients. However, it performed well for patients with cardiovascular diseases as the primary reason for admission and may thus be applied to these patients. Standardized mortality ratios that are calculated from scoring systems without known calibration must be viewed with skepticism.
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Intensive care medicine · Feb 1999
Case ReportsARDS in a patient with homozygous beta-thalassemia due to yersiniosis.
We report a case of Yersinia enterocolitica sepsis syndrome and the acute respiratory distress syndrome in a chronically transfused adolescent with beta-thalassemia. This manifestation of serious Y. enterocolitica infection has not previously been reported. Dyspnea, hypoxia, and fever were the principal features of the clinical presentation. ⋯ Y. enterocolitica was identified from blood and intraoperative appendix cultures. Although there was no need for mechanical ventilation, a remarkable persistence of clinical and X-ray findings was noted. Therapy with high levels of oxygen, and intravenous amikacin and piperacillin/tazobactam led to a favorable outcome.