Intensive care medicine
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Intensive care medicine · Jan 1991
Clinical TrialAdrenaline in treatment of septic shock: effects on haemodynamics and oxygen transport.
The effects of adrenaline on haemodynamics and oxygen transport were studied in 13 patients with septic shock persisting after optimal fluid loading. Adrenaline was administered by intravenous infusion at an increasing dose until no further benefit was seen. ⋯ There was a significant reduction in oxygen extraction ratio, but no change in shunt fraction. Adrenaline would appear to have beneficial haemodynamic effects in septic shock.
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Intensive care medicine · Jan 1991
Comment Letter Case ReportsCPAP with a Siemens Servo 900C ventilator during weaning in infants.
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Intensive care medicine · Jan 1991
Comparative StudyHigh frequency jet ventilation in experimental pulmonary emphysema.
The effects of high frequency jet ventilation (HFJV, f = 2 Hz and 8 Hz, I:E = 0.43, FiO2 = 0.4) were studied and compared with intermittent positive pressure ventilation (IPPV, f = 10-14 breaths/min, VT = 15 ml/kg, I:E = 0.5, FiO2 = 0.4) in 8 dogs before and after induction of panlobular emphysema (PLE). PLE increased alveolar-arterial PO2 difference (PA-aO2) during all modes of ventilation, whereas PaCO2 did not change significantly. In both periods of the study, HFJV8 Hz was less effective in terms of CO2-elimination and oxygenation. ⋯ In the PLE-period, FRC and CV increased significantly to 1107 +/- 207 ml and 14.1 +/- 7.0% VC respectively during IPPV (P less than 0.05). Application of HFJV neither increased FRC (HFJV2 Hz: 1153 +/- 433 ml, HFJV8 Hz: 1005 +/- 344 nor CV 14.8 +/- 6.0% VC and 13.9 +/- 8.1% VC, respectively). It is concluded that HFJV induces no alveolar overdistension in dogs with emphysematous lungs.
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Intensive care medicine · Jan 1990
Randomized Controlled Trial Comparative Study Clinical TrialNosocomial maxillary sinusitis during mechanical ventilation: a prospective comparison of orotracheal versus the nasotracheal route for intubation.
Nosocomial maxillary sinusitis during mechanical ventilation may cause life-threatening complications in ICU patients. The aim of this prospective study was to compare the incidence of maxillary sinusitis according to the route of intubation. 111 consecutive adult patients (mean age: 53, mean SAPS: 12) were randomly assigned to receive either orotracheal (n = 53) or nasotracheal (n = 58) intubation. All had a nasogastric feeding tube. ⋯ This procedure proved successful in 12 out of 17 cases but secondary drainage was performed in 5 cases (1 failure). Incidents related to the route for long-term intubation were significantly (p less than 0.001) more frequent in the orotracheal group (8/53 vs 2/58), however no patient died because of them. In this study, long-term orotracheal intubation reduced significantly the incidence of maxillary sinusitis in comparison with nasotracheal intubation.