Intensive care medicine
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Intensive care medicine · Nov 1994
Randomized Controlled Trial Clinical TrialContribution of non-neurologic disturbances in acute physiology to the prediction of intensive care outcome after head injury or non-traumatic intracranial haemorrhage.
To study the additional contribution of non-neurologic disturbances in acute physiology and chronic health to the prediction of intensive care outcome in patients with head injury or non-traumatic intracranial haemorrhage. ⋯ The non-neurologic disturbances in acute physiology have prognostic significance in the prediction of intensive care outcome in patients with head injury or non-traumatic intracerebral haemorrhage. The created predictive model may supplement clinical judgement of this patient group.
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Intensive care medicine · Nov 1994
Randomized Controlled Trial Clinical TrialUse of antithrombin III in critical patients.
To evaluate the effect of the AT III concentrates upon the clinical evolution and hemostatic parameters. ⋯ The results suggest that the administration of AT III concentrates to critical patients with acquired low levels, but without manifest DIC, may not be justified; although further studies on a larger population are required to establish definite conclusions.
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Intensive care medicine · Nov 1994
Comparative StudyInvasive monitoring combined with two-dimensional echocardiographic study in septic shock.
An investigation into the incidence and the clinical implication of discrepancies which may sometimes occur between invasive and non-invasive hemodynamic evaluation in septic patients. ⋯ Frequent discrepancies between to invasive and non-invasive procedure were observed. The reasons for these discrepancies, including low vascular resistance, reduced LV compliance, and a possible overestimation of cardiac output by the thermodilution method, are examined in the light of data recorded. It was concluded that invasive hemodynamic evaluation by right heart catheterization in septic patients should be seriously questioned.
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Intensive care medicine · Nov 1994
Platelet-activating factor and phospholipase A2 in patients with septic shock and trauma.
To study blood and bronchoalveolar lavage (BAL) fluid levels of platelet activating factor (PAF-acether) and phospholipase A2 (PLA2) in patients with septic shock or following severe trauma. ⋯ These results demonstrate a significant increase of both PLA2 and PAF-acether in the circulation of trauma patients, and a further increase in septic shock patients. It is possible that PAF-acether and PLA2 can be used as markers for the severity of the disease in septic shock and following severe trauma.
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Although only 5-10% of all hospitalized patients are treated in ICUs, they account for approximately 25% of all nosocomial infections, and the incidence of nosocomial infections in ICUs is 5-10 times higher than that observed in general hospital wards. Systemic and respiratory infections are far more common than in general wards, and most epidemics originate in ICUs. Nosocomial infections are the primary focus of most infection control programmes because they are the cause of high mortality rates in ICUs. ⋯ A simple and inexpensive way to reduce nosocomial infections in ICUs is to ensure that staff disinfect their hands after dealing with a patient. Intravascular devices, mechanical ventilation and urinary catheterization are major risk factors for nosocomial infections, and their use should be evaluated daily and discontinued as soon as clinically possible. Selective decontamination of the digestive tract and the use of standard immunoglobulin for prophylaxis are still controversial and need further investigation.(ABSTRACT TRUNCATED AT 250 WORDS)