Critical care medicine
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Critical care medicine · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialUse of a computerized advanced cardiac life support simulator improves retention of advanced cardiac life support guidelines better than a textbook review.
To determine whether an advanced cardiac life support (ACLS) computer simulation program improves retention of ACLS guidelines more effectively than textbook review. ⋯ Use of a computerized ACLS simulation program improves retention of ACLS guidelines better than textbook review.
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Critical care medicine · Apr 1999
Randomized Controlled Trial Multicenter Study Clinical TrialEffect of the immunomodulating agent, pentoxifylline, in the treatment of sepsis in prematurely delivered infants: a placebo-controlled, double-blind trial.
To evaluate the influence of the methylxanthine derivative, pentoxifylline, on plasma levels of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1, and IL-6 in prematurely delivered infants with generalized bacterial infections and to assess the effect of this immunomodulating drug on the clinical outcome in newborns with sepsis. ⋯ Pentoxifylline significantly affects the synthesis of TNF and IL-6 as well as reduces the mortality rate in premature infants with sepsis. The dosage and schedule of drug administration in this study attenuated the severity of the clinical course of sepsis in this group of patients.
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Critical care medicine · Apr 1999
Randomized Controlled Trial Multicenter Study Clinical TrialEffects of ibuprofen on the physiology and survival of hypothermic sepsis. Ibuprofen in Sepsis Study Group.
The objective was to compare the clinical and physiologic characteristics of febrile septic patients with hypothermic septic patients; and to examine plasma levels of cytokines tumor necrosis factor alpha (TNF-alpha and interleukin 6 (IL-6) and the lipid mediators thromboxane B2 (TxB2) and prostacyclin in hypothermic septic patients in comparison with febrile patients. Most importantly, we wanted to report the effect of ibuprofen treatment on vital signs, organ failure, and mortality in hypothermic sepsis. ⋯ Hypothermic sepsis has an incidence of approximately 10% and an untreated mortality twice that of severe sepsis presenting with fever. When compared with febrile patients, the hypothermic group has an amplified response with respect to cytokines TNF-alpha and IL-6 and lipid mediators TxB2 and prostacyclin. Treatment with ibuprofen may decrease mortality in this select group of septic patients.
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Critical care medicine · Apr 1999
Randomized Controlled Trial Clinical TrialStress doses of hydrocortisone reverse hyperdynamic septic shock: a prospective, randomized, double-blind, single-center study.
To investigate the effects of stress doses of hydrocortisone on the duration of vasopressor therapy in human septic shock. ⋯ Infusion of stress doses of hydrocortisone reduced the time to cessation of vasopressor therapy in human septic shock. This was associated with a trend to earlier resolution of sepsis-induced organ dysfunctions. Overall shock reversal and mortality were not significantly different between the groups in this low-sized single-center study.
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Critical care medicine · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialEffects of pressure ramp slope values on the work of breathing during pressure support ventilation in restrictive patients.
To investigate, in restrictive patients, the influence of pressure ramp slope values on the efficacy of pressure support ventilation. ⋯ Among the four tested slope values, the steepest was that which induced the lowest possible work of breathing in restrictive patients ventilated by pressure support ventilation. In this type of patient, we therefore suggest that the programmed pressure value should be reached by using a steep pressure ramp slope.