Critical care medicine
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Critical care medicine · Jan 2007
Randomized Controlled Trial Multicenter StudySelenium in Intensive Care (SIC): results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock.
Sepsis is associated with an increase in reactive oxygen species and low endogenous antioxidative capacity. We postulated that high-dose supplementation of sodium-selenite would improve the outcome of patients with severe sepsis and septic shock. ⋯ The adjuvant treatment of patients with high-dose sodium-selenite reduces mortality rate in patients with severe sepsis or septic shock.
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Critical care medicine · Jan 2007
Randomized Controlled TrialFeed intolerance in critical illness is associated with increased basal and nutrient-stimulated plasma cholecystokinin concentrations.
Delayed gastric emptying and intolerance to gastric feeding occur frequently in the critically ill. In these patients, gastric motor responses to nutrients are disturbed. Cholecystokinin (CCK) slows gastric emptying. The aim of this study was to determine plasma CCK concentrations during fasting and in response to small-intestine nutrient infusion in critically ill patients. ⋯ Both fasting and nutrient-stimulated plasma CCK concentrations are increased in critically ill patients, particularly in those with feed intolerance. This may provide a humoral mechanism for delayed gastric emptying seen in critical illness.
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Critical care medicine · Jan 2007
Randomized Controlled Trial Comparative StudyHigh-frequency oscillatory ventilation following prone positioning prevents a further impairment in oxygenation.
The improvement in oxygenation with prone positioning is not persistent when patients with acute respiratory distress syndrome (ARDS) are turned supine. High-frequency oscillatory ventilation (HFOV) aims to maintain an open lung volume by the application of a constant mean airway pressure. The aim of this study was to show that HFOV is able to prevent the impairment in oxygenation when ARDS patients are turned back from the prone to the supine position. ⋯ HFOV maintained the improvement in oxygenation related to prone positioning when ARDS patients were returned to the supine position.
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Critical care medicine · Jan 2007
Randomized Controlled TrialSalmeterol enhances pulmonary fibrinolysis in healthy volunteers.
Various lung diseases are associated with local activation of coagulation and concurrent inhibition of fibrinolysis. Although salmeterol, a beta2-adrenoceptor agonist with profound bronchodilatory properties, has been studied extensively, the effects of this compound on the pulmonary hemostatic balance are not elucidated. ⋯ Salmeterol has profibrinolytic properties in the normal lung and when applied in a model of sterile pulmonary inflammation.