Intensive care medicine
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Intensive care medicine · Apr 1995
Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock: incidence, morbidities and outcomes in surgical ICU patients.
To determine the incidence of systemic inflammatory response syndrome (SIRS), sepsis and severe sepsis in surgical ICU patients and define patient characteristics associated with their acquisition and outcome. ⋯ Almost everyone in the SICU had SIRS. Therefore, because of its poor specificity, SIRS was not helpful predicting severe sepsis and septic shock. Patients who developed sepsis or severe sepsis had higher crude mortality and length of stay than those who did not. Studies designed to identify those who develop complications of SIRS would be very useful.
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Intensive care medicine · Apr 1995
Thyroid and thymic endocrine function and survival in severely traumatized patients with or without head injury.
Functional links among the brain, endocrine and immune system have been described previously. An impairment of both immunological defence mechanisms and thyroid hormone turnover was present in trauma conditions. An investigation on the relevance of thymulin and thyroid hormones in multiple trauma patients with or without head injury has been performed. The role of these hormones as predictive factors for patients outcome was also evaluated. ⋯ Thymulin is markedly reduced in multiple trauma patients with head injury and it represents a predictive factor for the outcome better than the one deriving from the single measurements restricted to thyroid hormones.
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Intensive care medicine · Apr 1995
Smoke inhalation causes a delayed increase in airway blood flow to primarily uninjured lung areas.
Single lung inhalation injury causes tissue damage to the contralateral lung. We therefore examined airway blood flow after smoke inhalation in chronic instrumented sheep to get further information about the underlying pathophysiology. ⋯ Damage to one lung can lead to pathophysiologic changes in the contralateral lung. This response appears to be mediated by hematogenous factors.
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Intensive care medicine · Mar 1995
Comparative Study Retracted PublicationAlterations in circulating vasoactive substances in the critically ill--a comparison between survivors and non-survivors.
Regulation of circulatory homeostasis is based on several factors including various circulating vasoactive substances. Whether these regulators differ between survivors and non-survivors was investigated in critically ill patients. ⋯ Systemic and regional regulators of the circulation were markedly changed by critical illness. In survivors, these regulators almost normalized within the study period of 5 days, whereas in non-survivors these alterations were even aggravated. It can only be speculated whether these regulator systems were influenced by activation of various mediator systems or whether they themselves influenced the negative outcome in the non-survivors.
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Intensive care medicine · Mar 1995
Randomized Controlled Trial Comparative Study Clinical TrialEffects of inhaled nitric oxide on right ventricular function in severe acute respiratory distress syndrome.
To compare the effects of inhaled nitric oxide (NO) and an infusion of prostacyclin (PGI2) on right ventricular function in patients with severe acute respiratory distress syndrome (ARDS). ⋯ Using a new approach to selective pulmonary vasodilation by inhalation of NO, we demonstrate in this group of ARDS patients that an increase in RVEF is not necessarily associated with a rise in CI. The increase in CI during PGI2 infusion is probably related to the systemic effect of this substance.