Intensive care medicine
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Intensive care medicine · Aug 1998
An investigation into the effects of midazolam and propofol on human respiratory cilia beat frequency in vitro.
Patients in intensive care are known to be prone to both upper and lower respiratory tract infection. Respiratory mucus forms a barrier to infection. Mucus transport rate (MTR) depends upon both the physical properties of mucus and the action of respiratory cilia. Patients undergoing anaesthesia are known to have a reduced MTR that may be related to a depressant effect on cilia beat frequency (CBF) by anaesthetic drugs. The aim of this study was to investigate the effects of two commonly used intensive care sedative agents, midazolam and propofol, on CBF using human nasal turbinate explants in vitro. ⋯ We have found no effect of midazolam or propofol in supra-clinical concentrations upon CBF in human turbinate explants after a 90-min exposure. This contrasts with previous work that has shown a depressant effect of inhalational anaesthetic agents on CBF.
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Intensive care medicine · Aug 1998
Case ReportsAnticoagulative effect of nitric oxide inhalation in ARDS.
Some studies have suggested that nitric oxide (NO) may cause platelet dysfunction. We present an ARDS patient who need this treatment, with a transient alteration of platelet function and a significant prolongation of bleeding time.
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Intensive care medicine · Aug 1998
Electrical impedance tomography in monitoring experimental lung injury.
To apply electrical impedance tomography (EIT) and the new evaluation approach (the functional EIT) in monitoring the development of artificial lung injury. ⋯ The development of the local impairment of pulmonary ventilation and the formation of lung oedema could be followed by EIT in an experimental model of lung injury. This technique may become a useful tool for monitoring local pulmonary ventilation in intensive care patients suffering from pulmonary disorders associated with regionally reduced ventilation, fluid accumulation and/or cell membrane changes.
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To elucidate the risk factors for the development of acute renal failure (ARF) in severe trauma. ⋯ The identified risk factors for post-traumatic acute renal failure may help the provision of future strategies.
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Intensive care medicine · Aug 1998
In vitro activity of fleroxacin against multiresistant gram-negative bacilli isolated from patients with nosocomial infections.
In order to evaluate the in vitro activity of fleroxacin against nosocomial gram-negative organisms, 263 multiresistant gram-negative bacilli (203 Enterobacteriaceae and 60 non-fermenting gram-negative bacilli) were isolated from adult patients with nosocomial infections. The different patterns of resistance to eight different antimicrobial agents (ampicillin, carbenicillin, piperacillin, cephalothin, cefamandole, ceftazidime, gentamicin and amikacin) were determined by minimum inhibitory concentration (MIC), using the agar dilution method. The most prevalent multiresistant species isolated were Klebsiella pneumoniae (28.9%), Escherichia coli (24%) and Pseudomonas aeruginosa (12.2%). ⋯ The resistance to fluoroquinolones detected in this study was no cause for alarm (3%). Consequently, fleroxacin maintains a remarkable activity against Enterobacteriaceae and remains highly active against other gram-negative bacilli. Nevertheless, actions directed at preventing or limiting resistance will be crucial to maintain the viability of fluoroquinolones as important therapeutic agents.