Clinical intensive care : international journal of critical & coronary care medicine
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The transition from mechanical ventilation to spontaneous breathing in the intensive care unit is a two-stage process: weaning and extubation. Certain parameters require consideration before the commencement of weaning, namely respiratory function (both pulmonary gas exchange and respiratory muscle strength), cardiovascular status, stability of clinical condition, low metabolic demands, psychological factors and, possibly, patient collaboration. Appropriate sedation is crucial for successful weaning to keep the patient rested and to maintain the oxygen consumption and carbon dioxide production low. ⋯ This transition may be considered to comprise two separate stages, namely weaning and extubation. Weaning consists of preparation for spontaneous breathing supported and monitored by a mechanical ventilator and attendant monitoring of all the important vital parameters, while extubation marks the final switch to unsupported spontaneous breathing, which may be quite a big step for the patient. Important weaning parameters.
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Clin Intensive Care · Jan 1994
ReviewA multi-disciplinary approach to families of brain dead children.
To relate our multi-disciplinary approach to families of brain dead children. ⋯ Our multi-disciplinary approach may assist clinicians and other health care providers in successfully dealing with families of brain dead children.
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Clin Intensive Care · Jan 1994
Clinical TrialTreatment of acute respiratory failure with non-invasive intermittent positive pressure ventilation in haematological patients.
The aim of this study was to assess whether non-invasive positive pressure ventilation delivered intermittently (Ni-IPPV) by means of a facial or nasal mask is beneficial in haematological patients suffering from acute respiratory failure. ⋯ This technique is able to provide adequate ventilatory support for many haematological patients and allows avoidance of ventilation in some.
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Clin Intensive Care · Jan 1994
Impaired glucose and lipid metabolism seen in intensive care patients is related to severity of illness and survival.
To relate glucose and lipid metabolism to the severity of illness and survival in critically ill patients. ⋯ In a sample of unselected critically ill patients indices of both glucose and lipid metabolism were found to be related to the severity of illness as well as to the occurrence of sepsis and survival.
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Clin Intensive Care · Jan 1994
Metabolic effects of continuous veno-venous haemofiltration in critically ill patients.
To evaluate the short-term metabolic and haemodynamic effects of continuous veno-venous haemofiltration (CVVH) in critically ill patients with acute renal failure (ARF). ⋯ CVVH does not affect metabolic rate and haemodynamic stability in critically ill patients. The lack of any effect on the metabolic rate and haemodynamic parameters in such patients may have significant clinical importance and it further attests to the suitability of CVVH for the treatment of critically ill patients.