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 Clinical Trial[Effect of kinetic therapy on the course of treatment of patients with post-traumatic lung failure].
This study was conducted to investigate the effects of intermittent prone positioning of patients with post-traumatic respiratory failure (paO2/FiO2 < 280 mm Hg) in comparison with conventional therapy in a supine position. Although the severity of injury of the prone-positioned patients was much higher (ISS 35.8 vs 24.5), the ventilation time (32 vs 31 days) and ICU stay (39 vs 36 days) were similar to patients treated in the supine position. Besides the beneficial effect of prone positioning on oxygenation, for the first time we have evidence that prone positioning improves the outcome of patients with post-traumatic respiratory failure.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Efficacy of an Acute Pain Service--a controlled comparative study of hospitals].
The efficacy of an acute pain service was prospectively evaluated on elective abdominal operations by comparing two surgical departments including a total of 498 patients. The patients of the clinic with an acute pain service reported less pain (at rest and in movement) pre- and postoperatively and received more analgetics. They had more appetite, lower sleep requirements and more independence. The patients' overall satisfaction was greater in the clinic with an acute pain service.
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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 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Titanium implants in accident surgery--when are they necessary?].
The decision on whether to use stainless steel or commercial pure titanium as an implant material in open reduction and internal fixation (ORIF) should depend on biomechanical behavior, biocompatibility, resistance to infection, handling characteristics and costs. Based on the results of a prospective randomized clinical study including 281 DC-plates and data available in the literature we will present recommendable guidelines for the choice of the appropriate implant material for individual cases of bone surgery.