Intensive care medicine
-
Intensive care medicine · Jan 1993
Randomized Controlled Trial Comparative Study Clinical TrialAnticoagulant regimens in acute continuous hemodiafiltration: a comparative study.
To compare and contrast different heparin regimens for extracorporeal circuit anticoagulation in patients receiving acute continuous hemodiafiltration (ACHD). ⋯ Regional anticoagulation leads to longer filter survival than low dose heparin in shunt CAVHD. A regimen of no anticoagulation during femoral CAVHD leads to a filter life similar to that of low dose heparinization. During CVVHD, regional anticoagulation and low dose heparin are associated with similar filter survival times. In patients assessed to be at high risk of bleeding, treatment with CVVHD without anticoagulation results in adequate filter survival.
-
Intensive care medicine · Jan 1993
Continuous veno-venous haemofiltration following cardio-pulmonary bypass. Indications and outcome in 35 patients.
To study the impact of continuous veno-venous haemofiltration on survival in patients with acute renal failure (ARF) following cardio-pulmonary bypass (CPB) surgery. ⋯ Despite the theoretical advantages of haemofiltration and the effective control of uraemia the mortality associated with ARF following CPB remains high and is probably determined by the number of failed organs systems.
-
Intensive care medicine · Jan 1993
Comparative StudyThe use of neuromuscular blocking drugs in the intensive care unit: a US perspective.
Surprisingly little is known about the use of neuromuscular blockers (NMBs) in intensive care units (ICUs) in the USA. Recently, Klessig et al. surveyed anesthesiologists/intensivists in the USA and found that the 55% who responded used NMBs in the ICU in an average of 10 patients per ICU per month. Anxiolytics and analgesics were administered concomitantly with NMBs, but a majority of respondents did not use electrophysiologic measures of the degree of blockade. ⋯ More than half the patients were treated for < or = 24 h, the remainder for 2 days to > 3 weeks. Twitch monitors were used for monitoring the degree of neuromuscular blockade in adult patients, and all patients received sedatives/analgesics. We estimated that the risk of clinically significant, prolonged neuromuscular blockade following the discontinuation of NMBs was 5% per year.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Intensive care medicine · Jan 1993
Case ReportsAssessment of lung volume and alveolar pressure during combined high-frequency jet ventilation in a child with adult respiratory distress syndrome.
Lung volume and alveolar pressure were assessed using inductance plethysmography, airway occlusion and pneumotachography in a child with severe adult respiratory distress syndrome during both conventional mechanical and combined high-frequency ventilation (HFJV). The results suggest that improved oxygenation during combined HFJV is associated with higher end-expiratory lung volume and lower peak and mean lung volume and alveolar pressure.
-
Intensive care medicine · Jan 1993
Management of intra-abdominal organ injury following blunt abdominal trauma in children.
To evaluate the strategy of a combined diagnostic and therapeutic approach in children with intra-abdominal organ injury following blunt abdominal trauma. ⋯ The stepped diagnostic approach combined with initial non-surgical treatment by a team provided accurate diagnosis and appropriate treatment. Abdominal US, by demonstrating free intra-abdominal fluid is very sensitive to detect patients with intra-abdominal organ injury, CT scan with contrast is needed to give precise information of specific organ lesions.