Intensive care medicine
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Intensive care medicine · Dec 1996
Comparative StudyPressure-limited ventilation with permissive hypercapnia and minimum PEEP in saline-lavaged rabbits allows progressive improvement in oxygenation, but does not avoid ventilator-induced lung injury.
To determine whether pressure-limited intermittent mandatory ventilation with permissive hypercapnia and positive end-expiratory pressure (PEEP) titrated to arterial oxygen tension (PaO2) prevents or reduces acute lung injury, compared to conventional ventilation, in saline-lavaged rabbits. ⋯ This ventilatory protocol may have failed to prevent lung overdistension or it may have provided insufficient PEEP to prevent injury in this model; PEEP greater than the lower inflection point of the pressure-volume curve has been shown to prevent injury almost entirely.
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Intensive care medicine · Dec 1996
Assessment of depth of midazolam sedation using objective parameters.
To determine the relationship between the clinically evaluated depth of midazolam-induced sedation and the cardiac beat-to-beat variability (RR variability) in ICU patients in the intensive care unit (ICU). ⋯ In ICU patients, a significant correlation is found between the depth of midazolam-induced sedation as assessed by the Ramsay sedation score and RR variability, with a clinically sufficient prediction accuracy. RR variability can serve as an objective, continuously available, and non-invasive measurement to monitor midazolam-induced sedation in intubated and mechanically ventilated patients.
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Intensive care medicine · Dec 1996
Routine daily chest radiography is not indicated for ventilated patients in a surgical ICU.
To determine a) if clinical examination can accurately predict radiological change and b) if routine chest radiography is efficacious. ⋯ Clinical examination can effectively predict the need for radiography. Routine chest radiography is, therefore, not indicated for ventilated patients in our Surgical Intensive Care Unit.
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Intensive care medicine · Dec 1996
Severe community-acquired pneumonia in ICUs: prospective validation of a prognostic score.
To determine predictors of intensive care unit (ICU) mortality in patients with community-acquired pneumonia (CAP), to develop a pneumonia-specific prognostic index, and to evaluate this index prospectively. ⋯ This index, which performs well in classifying patients at high-risk of death, may help physicians in initial patient care (appropriateness of the initial antimicrobial therapy) and guide future clinical research (analysis and design of therapeutic trials).