Intensive care medicine
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Intensive care medicine · Apr 1998
Bronchoalveolar lavage fluid characteristics of early intermediate and late phases of ARDS. Alterations in leukocytes, proteins, PAF and surfactant components.
To determine the concentration of proteins and phospholipids, markers of inflammatory reaction such as platelet-activating factor (PAF), and cell alterations in bronchoalveolar lavage (BAL) fluid during the evolution of the acute respiratory distress syndrome (ARDS). ⋯ Total surfactant phospholipids, surfactant components, and inflammatory markers such as PAF, cells, and proteins were affected in patients with ARDS. These factors, undergoing quantitative alterations during the course of ARDS, could have a significant role in the pathogenesis and evolution of ARDS.
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Intensive care medicine · Apr 1998
Comparative StudyIntensive care training and specialty status in Europe: international comparisons. Task Force on Educational issues of the European Society of Intensive Care Medicine.
To describe current arrangements for postgraduate training and speciality status for intensive care medicine in Europe, and to compare these with three other geographical regions: the Middle East, North America, and Australia and New Zealand. ⋯ There is substantial support for multidisciplinary training in ICM, as demonstrated by collaborative interspeciality developments in many countries. We propose that these national developments should be strengthened within Europe by the recognition of 'supra-speciality' status for ICM by the European Commission, and by the establishment of a multidisciplinary Board for training in ICM, with international agreement on core competencies and duration of training programmes, and a common approach to the assessment of competence through formal examination.
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Intensive care medicine · Apr 1998
Critical care research and pre-emptive informed consent: a practical approach used in Chris Hani Baragwanath ICU.
1) To establish a protocol within international and local ethical guidelines to obtain informed consent for critical care research, overcoming constraints previously described and 2) To evaluate eventual recruitment using this protocol. ⋯ A policy of pre-emptive informed consent enabled us to overcome some of the problems previously experienced in our unit with regards to patient enrollment in critical care research. Although overall recruitment remained low, predictions for future enrollment can be made from this study.
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Intensive care medicine · Apr 1998
Randomized Controlled Trial Clinical TrialAcute normovolaemic haemodilution does not aggravate gastric mucosal acidosis during cardiac surgery.
Acute normovolaemic haemodilution with subsequent autologous blood transfusion after surgery is widely used to reduce homologous blood requirements during cardiac surgery. The hypothesis tested was whether a low intraoperative haematocrit (Hct) resulting from haemodilution decreases gastric mucosal pH (pHi). ⋯ Acute normovolaemic haemodilution does not aggravate gastric mucosal acidosis during cardiac surgery.
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To evaluate arterial lactate levels during treatment of acute severe asthma (ASA) and the prognostic value of arterial hyperlactatemia in ASA. ⋯ This study suggests that, in ASA, arterial hyperlactatemia is frequently present on admission to the ICU. Delayed hyperlactatemia is a constant finding during treatment of ASA. Initial or delayed hyperlactatemia seems of no prognostic value because none of the patients required mechanical ventilation. The effects of therapy for acute asthma on lactate metabolism still need to be studied.