Journal of critical care
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Journal of critical care · Dec 1997
Randomized Controlled Trial Clinical TrialTreatment with N-acetylcysteine during acute respiratory distress syndrome: a randomized, double-blind, placebo-controlled clinical study.
Intravenous N-acetylcysteine (NAC) has been reported to improve systemic oxygenation and reduce the need for ventilatory support in patients with an acute lung injury. In the more serious form, namely established adult respiratory distress syndrome (ARDS) (PaO2/FIO2 < or = 200 mm Hg), we tested the hypothesis that treatment with intravenous NAC may be beneficial. ⋯ In this relatively small group of patients presenting with an established ARDS subsequent to a variety of underlying diseases, intravenous NAC treatment during 72 hours neither improved systemic oxygenation nor reduced the need for ventilatory support.
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Journal of critical care · Dec 1997
Randomized Controlled Trial Clinical TrialFewer interventions in the immediate post-extubation management of pediatric intensive care unit patients: safety and cost containment.
The purpose of this article was to compare the safety and patient charges of two postextubation treatment regimens. ⋯ A modified postextubation management protocol, consisting of fewer interventions, resulted in significant patient charge savings with no increased risk to the patient.
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This study investigates heat shock protein 70 (HSP70) expression by peripheral blood mononuclear cells (PBMCs) of septic patients admitted to an intensive care unit and examines the possibility of a correlation between HSP70 levels and plasma tumor necrosis factor alpha (TNF-alpha) concentrations. Additionally, we evaluated whether the HSP70 production could be regarded as a prognostic factor for the development of septic shock as well as for patient survival. ⋯ These findings give further evidence that also in humans, heat shock response is activated during sepsis. The correlation observed between HSP70 overproduction and TNF-alpha plasma concentrations suggests that HSP70 exerts a possible protective effect against TNF-alpha cytotoxicity. Such hypothesis has not been confirmed by our clinical data.
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Journal of critical care · Dec 1997
Randomized Controlled Trial Clinical TrialStudy of some phagocyte membrane receptors in patients receiving intravenous polyvalent immunoglobulins as adjunct treatment for nosocomial pneumonia.
Phagocytosis is a major mechanism of defense against bacterial infections. The ingestion of bacteria by phagocytes involves a variety of cell membrane recognition structures and, among them, immunoglobulin receptors. The aim of this study was to test the phagocytic activity of granulocytes and monocytes of intensive care unit (ICU) patients, and to evaluate the effects of intravenous polyvalent immunoglobulins (IVIG) used as adjunct treatment of nosocomial pneumonia on some phagocyte membrane receptors of these patients. ⋯ Infected ICU patients display a deficiency of phagocytosis membrane receptors of blood granulocytes and monocytes. The addition of IVIG to standard therapy does not improve the phagocytic activity of ICU patients with nosocomial pneumonia.
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Journal of critical care · Dec 1997
Clinical TrialPreliminary clinical trial of an ex vivo arterial blood gas monitor.
The purpose of this study was to test the analytical performance of a new ex vivo arterial blood gas (ABG) monitor based on fiberoptic sensor technology (SensiCath; Optical Sensors, Inc., Minneapolis, MN) when operated by critical care practitioners in intensive care environments. ⋯ A practical ex vivo ABG monitor has been developed that offers accurate data and potential advantages to the critical care practitioner and the critically ill patient over other ABG analysis systems: one 10-minute calibration procedure; 1-minute analysis time; no permanent blood removal from the patient; and a closed arterial monitoring system. Precision performance is comparable to standard laboratory ABG analysis. The ABG monitor offers reliability and ease of use, and the ability of the critical care practitioner (nurse, respiratory therapist, or physician) to obtain accurate ABG analyses as needed at bedside.