Intensive care medicine
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Intensive care medicine · Oct 1996
Theoretical interactions between ventilator settings and proximal deadspace ventilation during tracheal gas insufflation.
To investigate the theoretical interactions between ventilator settings, tracheal gas insufflation (TGI), and alveolar ventilation. ⋯ During TGI with constant catheter flow, ventilator settings that promote end-expiratory flow of gas from the lung diminish proximal ventilation. When frequency increases, the decrease in dilution efficiency of the individual breath is partially offset by the increase in cycle number, an effect which is magnified by any concomitant decrease in inspired tidal volume. Prolongation of the duty cycle tends to decrease proximal ventilation. Increases in expiratory resistance, including those arising from the external ventilator circuit or the endotracheal tube, also impair proximal ventilation.
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Intensive care medicine · Oct 1996
Comparative StudyAnalysis of the accuracy of continuous thermodilution cardiac output measurement. Comparison with intermittent thermodilution and Fick cardiac output measurement.
To evaluate the accuracy of cardiac output measurement obtained by a new continuous thermodilution cardiac output (CCO) pulmonary artery catheter compared to intermittent thermodilution (TCO) and the direct Fick method. ⋯ CCO provides clinically acceptable measurements. At high cardiac outputs, the difference with other methods increases and the results must be cautiously interpreted.
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Intensive care medicine · Oct 1996
The influence of length of stay in the ICU on power of discrimination of a multipurpose severity score (SAPS). ARCHIDIA.
To assess how the power of discrimination of a multipurpose severity score (Simplified Acute Physiology Score; SAPS) changes in relation to the length of stay (LOS) in the intensive care unit (ICU). ⋯ The logistic model that we developed meets high standards for discrimination and calibration. However, SAPS loses its discriminative power over time; accuracy of prediction is maintained at an acceptable level only in patients who stay in the ICU no longer than 5 days. The stay in the ICU represents a complex variable, which is not predictable, that influences the performance of SAPS on the first day.
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Intensive care medicine · Oct 1996
Decisions to forego life-sustaining treatment and the duty of documentation.
To study the current practice of documenting decisions to forego life-sustaining treatment in an intensive care unit (ICU), using the Swedish Medical Records Act as a frame of reference. ⋯ The medical records give a fairly accurate picture of the frequency with which such decisions are made at this particular ICU, although the number might be somewhat underestimated. However, the content of the documentation is rather scanty and does not fully satisfy the requirements of the Swedish Medical Records Act. Further studies are needed to warrant any generalization.
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Intensive care medicine · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialImproved oxygenation utilizing a prone positioner in patients with acute respiratory distress syndrome.
(a) To determine whether placing patients with acute respiratory distress syndrome in the prone position by a light-weight portable support frame improves oxygenation, (b) whether one can determine which patients benefit from prone positioning, and (c) to determine an effective technique for prone positioning of patients. ⋯ Prone positioning improves oxygenation in the majority of patients studied and can be achieved relatively easily.