Intensive care medicine
-
Intensive care medicine · Jun 1995
Late outcome of percutaneous dilatational tracheostomy in intensive care patients.
Percutaneous dilatational tracheostomy is increasingly practiced in intensive care units and has a low incidence of early complications. The late effects of this procedure are still poorly known and were the focus of this study. ⋯ Late outcome of percutaneous dilatational tracheostomy in critically ill patients is mostly good. Pending further studies, the use of this technique in intensive care units appears justified.
-
Intensive care medicine · Jun 1995
Hemodynamic effects of high-frequency oscillatory ventilation in severe pediatric respiratory failure.
To assess the hemodynamic effects of high mean proximal airway pressures (Paw) during high-frequency oscillatory ventilation (HFOV) in non-neonatal pediatrics patients with severe respiratory failure. ⋯ High-Paw HFOV must be used cautiously, but seems to have no discernible adverse effects on the cardiovascular system in most patients.
-
Intensive care medicine · May 1995
Randomized Controlled Trial Clinical TrialRespiratory mechanics by least squares fitting in mechanically ventilated patients: applications during paralysis and during pressure support ventilation.
To evaluate a least squares fitting technique for the purpose of measuring total respiratory compliance (Crs) and resistance (Rrs) in patients submitted to partial ventilatory support, without the need for esophageal pressure measurement. ⋯ The LSF method allows non-invasive evaluation of respiratory mechanics during PSV, provided that a near-relaxation condition is obtained by means of an adequately increased pressure support level. The measurement of P0.1 may be helpful for titrating the pressure support in order to obtain the condition of near-relaxation.
-
Intensive care medicine · May 1995
Multicenter StudyQuality of life after intensive care with the sickness impact profile.
a) to validate the structure of the Sickness Impact Profile scale (SIP) when applied to intensive care patients after discharge from the hospital; b) to explore the influence of age upon the various components of quality of life. ⋯ The study validated the use of the SIP QOL-instrument on patients after intensive care. Age influenced consistently the various components of quality of life.
-
Intensive care medicine · May 1995
Clinical TrialKinetic of body nitrogen loss during a whole day infusion and withdrawal of glucose and insulin in injured patients.
To investigate the kinetics of body nitrogen (N) excretion during 24 h glucose infusion (relating glycemia with insulin supply) and during subsequent 24 h saline infusion in injured patients during a full blown stress reaction. To define the lag time between the start of the withdrawal of glucose and insulin infusion, and the modification in the N loss from the body, and the time span to reach the maximum effect and its size. The knowledge of these variables is mandatory to plan short term studies in critically ill patients, while assuring the stability of the metabolic condition during the study period, and also to assess the possible weaning of the effect on protein breakdown during prolonged glucose and insulin infusion. ⋯ 24 h glucose withdrawal reduces N and 3-MH loss injured patients, the drug-like effect is maintained during the first 12 h of withdrawal and thereafter disappears. The study suggests that at least a 24 h study period is necessary when planning studies exploring energy-protein metabolism relationship in injured patients, and, again 24 h before changing protocol in a crossover study.