Intensive care medicine
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Intensive care medicine · Aug 1995
Case ReportsMagnetic resonance imaging of cerebral fat embolism: a case report.
Fat embolism syndrome (FES) is one of the most important causes of morbidity and mortality following multiple fractures. Neurological involvement (cerebral fat embolism) has been reported frequently. ⋯ MRI follow-up (1 and 3 months post-trauma) showed nearly complete resolution of the abnormal signal. MRI seems to be a useful diagnostic tool for detecting and quantifying lesions in fat embolism syndrome.
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Intensive care medicine · Aug 1995
Randomized Controlled Trial Clinical TrialIncreased neutrophil elastase release in patients with cardiopulmonary arrest: role of elastase inhibitor.
To determine the changes in neutrophil elastase levels in patients with cardiac arrest occurring outside the hospital and to evaluate the effects of urinastatin on these changes and on the clinical outcomes of the patients. ⋯ Accompanying cardiopulmonary arrest and resuscitation, neutrophils are activated and elastase is released. Elevated elastase level is associated with poorer prognosis. Urinastatin can suppress the release of elastase, when utilized at the dose described in this study, did not improve the clinical outcomes of patients who had suffered an out-of-hospital cardiac arrest.
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To compare some of the confirmatory investigations of brain death with clinical criteria in order to achieve the most sensitive and accurate diagnosis of brain death. ⋯ Our study suggests that cerebral angiography and CBF studies are the most reliable investigations whereas the role of EEG and TCD remains to be determined because of the presence of false negatives and positives.
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Intensive care medicine · Aug 1995
Case ReportsInhaled nitric oxide for hemodynamic support after postpneumonectomy ARDS.
Inhaled nitric oxide (NO) has been reported to promote selective pulmonary vasodilation and better arterial oxygenation in cases of adult respiratory distress syndrome (ARDS) with pulmonary hypertension (PHT). However, the clinical relevance of these changes and their effects on outcome remain to be proven, since long-term inhalation carries a potential risk of toxicity. ⋯ NO resulted in better oxygenation and markedly improved hemodynamic status. As the underlying disease progressively worsened the patient became fully dependent on NO for hemodynamic support, and he died after 24 days of effective supportive therapy with inhaled NO.