Critical care : the official journal of the Critical Care Forum
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Abdominal compartment syndrome has been described in patients with severe acute pancreatitis, but its clinical impact remains unclear. We therefore studied patient factors associated with the development of intra-abdominal hypertension (IAH), the incidence of organ failure associated with IAH, and the effect on outcome in patients with severe acute pancreatitis (SAP). ⋯ IAH is a frequent finding in patients admitted to the ICU because of SAP, and is associated with a high occurrence rate of organ dysfunction. Mortality is high in patients with IAH, and because the direct causal relationship between IAH and organ dysfunction is not proven in patients with SAP, surgical decompression should not routinely be performed.
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Tracheostomies have been around for close to 3000 years, so one would hope that the controversies might have been thrashed out by now, but apparently not. Judging by some recent publications it would appear that we still do not know when or how to insert them. ⋯ The intensive care unit imposes a heavy treatment burden, particularly on the elderly. What impact does this have on the lives of the survivors?
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We observed an oscillatory flow while ventilating critically ill patients with the Dräger Oxylog 3000 transport ventilator during interhospital transfer. The phenomenon occurred in paediatric patients or in adult patients with severe airway obstruction ventilated in the pressure-regulated or pressure-controlled mode. As this had not been described previously, we conducted a bench study to investigate the phenomenon. ⋯ Oscillatory flow with potentially harmful effects may occur during ventilation with the Dräger Oxylog 3000, especially in conditions with high resistance such as small airways in children (endotracheal tube internal diameter <6 mm) or severe obstructive lung diseases or airway diseases in adult patients.