Intensive care medicine
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Intensive care medicine · Jul 1998
Acute hypoxemic respiratory failure in children: case mix and the utility of respiratory severity indices.
Acute hypoxemic respiratory failure (AHRF) is a common reason for emergency pediatric intensive care. An objective assessment of disease severity from acute physiological parameters would be of value in clinical practice and in the design of clinical trials. We hypothesised that there was a difference in the best early respiratory indices in those who died compared with those who survived. ⋯ The original hypothesis was refuted. It appears that the outcome of AHRF in present day pediatric critical care is principally related to the severity of associated pathology and now no longer solely to the severity of respiratory failure. Further studies in larger series are needed to confirm these findings.
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Intensive care medicine · Jul 1998
Comparative StudyBiochemical and ultra-structural reactions to parenteral nutrition with two different fat emulsions in rats.
To compare the effects on fat metabolism and Kupffer cell morphology by total parenteral nutrition (TPN) with two different fat emulsions. ⋯ Compared to treatment with pure LCTemulsions, treatment with MCT/LCT emulsions evoked weaker biochemical reactions in terms of lower activity of lipoprotein lipase in fat and heart together with higher serum and HDL triglyceride levels. Morphological signs of increased Kupffer cell activity such as the appearance of multiple lysosomes and fat vacuoles in the cytoplasm followed treatment with pure LCT emulsions. However, both TPN groups showed a marked increase in activities of liver lysosomal enzymes.
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Intensive care medicine · Jul 1998
Percutaneous dilatational tracheostomy--early results and long-term outcome of 326 critically ill patients.
To analyze perioperative and postoperative complications and long-term sequelae following percutaneous dilatational tracheostomy (PDT). ⋯ When performed by experienced physicians, percutaneous dilatational tracheostomy under fiberoptic guidance is a safe method. The risks of early complications and of clinically relevant tracheal stenoses are low. Subclinical tracheal stenoses are found in about 40% of patients following PDT.
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Intensive care medicine · Jul 1998
Case ReportsEthylene glycol poisoning treated by intravenous 4-methylpyrazole.
A 19-year-old woman was admitted 45 min after ethylene glycol (EG) ingestion. The initial serum EG concentration was 1.34 g/l (21.6 mmol/l), the anion gap 14.5, and the osmolal gap 24. ⋯ Ethanol therapy, hemodialysis, and sodium bicarbonate administration were not required. The half-life of EG during 4-MP therapy was 11 h, with a mean EG renal clearance of 26.9 ml/min, and a total of 65.3 g EG was eliminated unchanged in the urine. 4-MP therapy was also well tolerated.
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Intensive care medicine · Jun 1998
Case ReportsPlacement of a temporary pacemaker electrode through a persistent left superior vena cava.
Perioperative temporary pacing was needed in a patient with congenital skeletal malformations and a cardiac conduction disturbance with incomplete trifascicular block. We report the successful placement of the pacemaker electrode through a persistent left superior vena cava (SVC).