Intensive care medicine
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Intensive care medicine · Oct 1997
Congenital diaphragmatic hernia: antenatal prognostic factors : Does cardiac ventricular disproportion in utero predict outcome and pulmonary hypoplasia?
Despite regular progress in neonatal intensive care, congenital diaphragmatic hernia (CDH) diagnosed antenatally is still associated with up to 80 % mortality. It is impossible to predict which fetus with CDH will survive or not. ⋯ Our study confirmed the factors for a poor prognosis associated with CDH previously described in the literature, but none with a consistent demonstration of accuracy. LV hypoplasia may be a more accurate predictor of outcome and of PH but it has to be assessed by prospective studies with larger samples. Further basic science and Doppler-flow studies may be helpful to understand the natural history and pathophysiology of LV hypoplasia in CDH.
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Intensive care medicine · Oct 1997
Comparative Study Clinical TrialShort-term effects of prone position in critically ill patients with acute respiratory distress syndrome.
Changing the position from supine to prone is an emerging strategy to improve gas exchange in patients with the acute respiratory distress syndrome (ARDS). The aim of this study was to evaluate the acute effects on gas exchange, hemodynamics, and respiratory system mechanics of turning critically ill patients with ARDS from supine to prone. ⋯ Turning critically ill, severely hypoxemic patients from the supine to the prone position is a safe and useful therapeutic intervention. Our data suggest that prone positioning should be carried out early in the course of ARDS.
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Intensive care medicine · Oct 1997
Comparative Study Clinical TrialThe ability of the Simplified Acute Physiology Score (SAPS II) to predict outcome in coronary care patients.
To evaluate the applicability of the Simplified Acute Physiology Score (SAPS II) for coronary care patients. ⋯ We conclude that SAPS II is applicable to CCU patients in our unit.
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Intensive care medicine · Oct 1997
Comparative StudySeptic shock in patients with the acquired immunodeficiency syndrome.
To evaluate the prognosis of patients with septic shock admitted to an intensive care unit (ICU), according to their HIV serostatus. ⋯ This study reports a considerable excess mortality in HIV-infected patients with septic shock. Although severity of illness was clearly much more pronounced in HIV-positive patients, retroviral infection was independently associated with death. Improving survival in HIV-positive patients with septic shock may require earlier diagnosis and treatment of the causative infection.
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Intensive care medicine · Oct 1997
Comparative Study Clinical TrialIs endotoxin and cytokine release related to a decrease in gastric intramucosal pH after hemorrhagic shock?
(a) To investigate the relationship between gut ischemia parameters (gastric intramucosal pH [pHi], mucosal-arterial carbon dioxide difference [PCO2-gap]), and endotoxin or cytokine release during hemorrhagic shock; (b) to compare the predictive value of pHi, PCO2-gap and arterial lactate concentrations. ⋯ During severe hemorrhagic shock, endotoxin translocation from the gut was a common phenomenon that seemed independent of both pHi values and outcome. It could not explain IL-6 and TNF alpha release. In severe hemorrhagic shock, neither pHi nor PCO2-gap provides additional information to the lactate measurements.