Intensive care medicine
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Intensive care medicine · Jan 1994
Comparative StudyA new therapy of post-trauma brain oedema based on haemodynamic principles for brain volume regulation.
To evaluate a new therapy of posttraumatic brain oedema, with the main concept that opening of the blood-brain barrier upsets the normal brain volume regulation, inducing oedema formation. This means that transcapillary fluid fluxes will be controlled by hydrostatic capillary and colloid osmotic pressures, rather than by crystalloid osmotic pressure. If so, brain oedema therapy should include reduction of hydrostatic capillary pressure and preservation of normal colloid osmotic pressure. ⋯ The results indicate that the therapy should focus on extracellular rather than intracellular oedema and that ischemia is not the main triggering mechanism behind oedema formation. We suggest that our therapy is superior to conventional therapy by preventing herniation during the healing period of the blood-brain barrier.
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Intensive care medicine · Jan 1994
Comparative StudyHyperchloremic acidosis during grand mal seizure lactic acidosis.
To evaluate the prevalence and the mechanism of hyperchloremic acidosis component (HClA) during lactic acidosis secondary to grand mal seizures. ⋯ HClA component may be associated with lactic acidosis in grand mal seizures and appears to be secondary to a lactate antiport. This phenomenon could be an immediate physiological response to a sudden metabolic acidosis.
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Intensive care medicine · Jan 1994
Comparative StudyThe effect of hydroxyethyl starch and other plasma volume substitutes on endothelial cell activation; an in vitro study.
To study the effect of medium molecular weight hydroxyethyl starches on endothelial cell and neutrophil activation in vitro. ⋯ these results suggest a possible beneficial role of hydroxyethyl starches in the inhibition of endothelial activation thus preventing neutrophil adhesion during sepsis syndrome.
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Intensive care medicine · Jan 1994
Comparative StudyEvaluation of oxygen uptake and delivery in critically ill patients: a statistical reappraisal.
The evaluation of oxygen consumption (VO2) and oxygen delivery (DO2) has gained increasing importance in the monitoring of critically ill patients. They can be obtained from either direct measurements or by indirect calculations based on the Fick principle. However the choice between these two approaches remains controversial. The aim of the study was to investigate whether these 2 methods provide similar results, and if not, to define the best one in terms of reproducibility. ⋯ Our data suggested that the indirect calculation (Fick equation) and the direct measurement (indirect calorimetry, thermodilution) of both VO2 and DO2 did not provide similar results. Direct measurements are more reproducible methods and must be preferred.