Intensive care medicine
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Intensive care medicine · Jul 1997
Clinical Trial Controlled Clinical TrialThe effect of dobutamine infusion on splanchnic blood flow and oxygen transport in patients with acute pancreatitis.
To measure the blood flow distribution and oxygen transport in pancreatitis and to evaluate the regional effects of increased systemic blood flow. ⋯ In severe pancreatitis, oxygen consumption is increased in the splanchnic region; increased splanchnic oxygen demand is not always met by adequately increased blood flow. Increasing the systemic blood flow with dobutamine does not improve perfusion in the splanchnic bed.
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Intensive care medicine · Jul 1997
Case ReportsAcute colonic pseudoobstruction (Ogilvie's syndrome) in two patients receiving high dose clonidine for delirium tremens.
We describe two cases of severe colonic pseudo-obstruction (Ogilvie's Syndrome) after high dose clonidine i.v. infusions for delirium tremens. The first symptoms occurred 36 h and 5 days, respectively, after institution of therapy. ⋯ We conclude that the therapy of delirium tremens with high i.v. doses of clonidine carries the risk of provoking severe CPO, especially when other contributing factors are present. While therapy of the alcohol withdrawal syndrome with clonidine appears to be an attractive alternative to conventional treatment, ICU physicians should be alerted to this potentially serious complication.
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Intensive care medicine · Jul 1997
Out of hospital outcome and quality of life in survivors of combined acute multiple organ and renal failure treated with continuous venovenous hemofiltration/hemodiafiltration.
To study the out-of-hospital quality of life and long-term survival of critically ill patients with combined multiple organ failure and acute renal failure treated with continuous renal replacement therapy (CRRT). ⋯ In the majority of patients who survived to be discharged from hospital after combined acute multiple organ and renal failure, the overall state of health and quality of life seemed acceptable. Most patients felt that their treatment was worthwhile and that they would undergo the same treatment again if necessary. Our findings suggest that the cost and effort associated with CRRT and ICU care in these patients are high but broadly comparable to those associated with the care of other serious illnesses. They are also seen as worthwhile by survivors, who consider their life to be of acceptable quality.
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Intensive care medicine · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialIntermittent administration of furosemide versus continuous infusion in the postoperative management of children following open heart surgery.
To compare the amount of furosemide needed to fulfil defined criteria for renal output if given intermittently or as a continuous infusion and to compare the effect of these two regimens on hemodynamic variables and urine electrolyte concentrations. ⋯ Intermittent furosemide administration may be recommended in hemodynamically stable postoperative pediatric cardiac patients because of less drug requirement. However, the high maximal urine output may cause hemodynamic problems in patients who depend on high inotropic support.