Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Randomized Controlled Trial Clinical Trial[Cause-oriented prevention of nosocomial pneumonia: the HI-LO EVAC tube].
Surgical high-risk patients were studied in a prospective randomized trial regarding nosocomial pneumonia (NP) using a subglottic lavage (SL). A total of 100 patients were investigated, in whom the primary infection was localized in the oropharynx. Independent of the kind of stress ulcer prophylaxis, intermittent subglottic lavage reduces the incidence of NP drastically to 3%, which is however, without statistical significance.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Plasma separation combined with CVVHF in septic and SIRS patients].
In a prospective non-randomized trial, 59 patients with sepsis (n = 43) and SIRS (n = 16) were treated on a surgical intensive care unit. In 22 patients plasmapheresis in combination with continuous venovenous hemofiltration (CVVHF) was administered. Lethality was 56% in the sepsis group; in the therapy group lethality was significantly lower in patients with plasmapheresis, even though in this population the organic failure rate was higher. ⋯ Lethality at 22% in the plasmapheresis group with double organ failure was significantly lower (P > 0.01) than in controls. Reduction of lethality seemed to be as high as 18% in patients with sepsis, while patients with SIRS did not profit from the additional therapy. A prospective randomized trial in sepsis and double organic failure should be projected.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Tumor necrosis factor-alpha (TNF-alpha) gene polymorphism in surgical intensive care patients with SIRS].
Biallelic polymorphism in the promotor region of the TNF-alpha gene have been associated with variation in TNF-alpha production. We determined the TNFA polymorphism (position--308) and related these data to plasma cytokine levels of TNF alpha, IL6, IL6R and IL8 in patients with SIRS and sepsis. Although there seems to be a different cytokine secretion pattern for both allelic groups (TNFA1 and TNFA2), a clear risk group could not be determined. It still remains unclear whether there is a genetic factor that influences the development of sepsis and multi organ failure.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Comparative Study[Quality of life after inguinal hernia operation--results of a prospective study (Shouldice, Lichtenstein, TAPP)].
Data concerning quality of life and rehabilitation after inguinal hernia repair are still poor. A prospective survey on 269 patients was conducted following standardized Shouldice, Lichtenstein and TAPP hernioplasty by means of questionnaire. General health perception, pain scores and physical activity were significantly improved by all of the mentioned techniques. Laparoscopic repair was beneficial in indirect, recurrent and bilateral hernia and small defects of the transverse fascia.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
[Intensive care medicine from the viewpoint of patients, their family and nursing personnel].
We wanted to know how our intensive care unit would be graded by the patients, their family members and the staff, as well as the impression that intensive care medicine made on them. A total of 82% of the patients and 90% of the family members were of the opinion that they owed their lives to intensive care medicine, and 100% of the patients and 96% of family members deemed intensive care medicine significant. ⋯ The nursing staff held a contrary opinion and were more critical. Competent explanation and transmission of information represented the most important factor in forming a positive opinion of intensive care medicine.