Critical care medicine
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Critical care medicine · Jun 2007
Editorial CommentHigh-frequency oscillation: how high should we go?
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Critical care medicine · Jun 2007
Randomized Controlled TrialAutomatic control of tracheal tube cuff pressure in ventilated patients in semirecumbent position: a randomized trial.
The aspiration of subglottic secretions colonized by bacteria pooled around the tracheal tube cuff due to inadvertent deflation (<20 cm H2O) of the cuff plays a relevant role in the pathogenesis of ventilator-associated pneumonia. We assessed the efficacy of an automatic, validated device for the continuous regulation of tracheal tube cuff pressure in preventing ventilator-associated pneumonia. ⋯ Cuff pressure is better controlled with the automatic device. However, it did not result in additional benefits to the semirecumbent position in preventing ventilator-associated pneumonia.
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Critical care medicine · Jun 2007
Tidal volume delivery during high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome.
a) Characterize how ventilator and patient variables affect tidal volume during high-frequency oscillatory ventilation; and b) measure tidal volumes in adults with acute respiratory distress syndrome during high-frequency oscillatory ventilation. ⋯ Tidal volumes are not uniformly small during high-frequency oscillatory ventilation. The primary determinant of tidal volume in adults with acute respiratory distress syndrome during high-frequency oscillatory ventilation with the Sensormedics 3100B is frequency. Test lung findings suggest that endotracheal tube internal diameter is also an important determinant of tidal volume.
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Critical care medicine · Jun 2007
Clinical TrialGender differences in the innate immune response and vascular reactivity following the administration of endotoxin to human volunteers.
To determine gender differences in the innate immune response and vascular reactivity during human endotoxemia. ⋯ During experimental human endotoxemia, females showed a more pronounced proinflammatory innate immune response associated with less attenuation of norepinephrine sensitivity. These findings may be relevant in view of the profound and incompletely explained differences in incidence and outcome of sepsis among male and female patients.