Clinical intensive care : international journal of critical & coronary care medicine
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Clin Intensive Care · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialHaemodynamic effects of pressure-controlled ventilation versus volume-controlled ventilation in patients submitted to cardiac surgery.
To compare the haemodynamic effects of pressure-controlled ventilation (PCV) with volume-controlled ventilation (VCV) in patients after cardiac surgery. ⋯ PC and VC ventilatory modes had comparable effects on patients with preserved or depressed cardiac output. Patients ventilated with PCV showed significantly higher values for cardiac index, a decreased SVR, as well as significantly lower values for inspiratory pressure when compared with VCV patients.
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Despite more than 25 years of extensive research the mortality of ARDS patients remains high. Besides the often deleterious course of the underlying disease, another reason for this high mortality lies in the aggressive ventilatory regimen which is required to maintain arterial blood gases in a more or less normal range. Therapeutic methods which are used to reduce iatrogenic damage to the lungs are pressure controlled ventilation with permissive hypercapnia, differential lung ventilation, positioning therapy, dehydration, and extracorporeal gas exchange with membrane lungs. ⋯ Therefore, the need remains to develop new therapeutic strategies and to investigate their influence on the morbidity and mortality of this life-threatening disease. First experiences with nitric oxide (NO) inhalation, intravenous application of antioxidants, intratracheal instillation of surfactant, tracheal gas insufflation and combined fluid/gas ventilation with perfluorocarbon are presented. All these new methods have proved their efficacy, at least in animal studies, however, they should still be regarded as experimental.
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Clin Intensive Care · Jan 1995
ReviewThe aetiology, consequences and prevention of barotrauma: a critical review of the literature.
To review critically the literature on pulmonary barotrauma in mechanically ventilated patients. ⋯ Pulmonary barotrauma is a clinically important phenomenon that may delay the healing of injured lungs and lead to the development, or the exacerbation, of ARDS. Risk factors for barotrauma include high peak airway pressures, large tidal volumes and acute lung injury. Resolution of the role for pressure-limited ventilation in ARDS prevention and treatment requires a large-scale randomised clinical trial.
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Clin Intensive Care · Jan 1995
Near infrared spectroscopy during and after cardiac arrest--preliminary results.
To evaluate if regional cerebrovascular oxygen saturation (rSO2) is linked to systemic oxygenation and if impaired regional cerebral oxygenation affects outcome in cardiac arrest patients. ⋯ By showing that low rSO2 readings after cardiac arrest are associated with a higher mortality, this new, non-invasive and easily applicable technique might help to prognosticate outcome and offers new insights into monitoring cerebral oxygenation after cardiac arrest.
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Clin Intensive Care · Jan 1995
Comparative StudyComparison of APACHE III, II and the Glasgow Coma Scale for prediction of mortality in a neurosurgical intensive care unit.
This study examined the efficacy of predicting power for hospital mortality of three different scoring systems in a neurosurgical intensive care unit (NICU). ⋯ The APACHE III system seems to be the most reliable. The results reveal that the APACHE III system is better in predicting power for hospital mortality than either the GCS or APACHE II systems in our NICU patients.