Articles: critical-care.
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Ever-increasing knowledge of the pathomechanisms and the phasic pathogenesis of ARDS has increased the demand for adequate monitoring and has modified therapeutic strategies. The influence of monitoring by double indicator dilution technique (COLD system) with the close measurement of extravascular lung water on the diagnosis and therapy of ARDS is presented. Pressure-controlled ventilation (< 35 cm H2O) in combination with moderate PEEP, kinetic therapy (prone position) and elective CVVH already in the early stages of ARDS can be regarded as the standard therapy. The effectiveness of NO inhalation, prostaglandins and radical scavengers still has to be improved in controlled clinical trials.
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Ann Fr Anesth Reanim · Jan 1997
Review[How to demonstrate, correct and prevent tissue hypoxia in intensive care patients? 3rd European Consensus Conference on intensive care organized by the French Language Intensive Care Society with the American Thoracic Society and the European Society of Intensive Care Medicine. Versailles, December 7-8, 1995].
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Algorithms represent a graphical display of decision-making by giving clearly defined and formalized guidelines. The systematic order of decisions and consequent actions is guided by medical priority and regulates the time frame and sequence of each single step in a logical manner. With the help of clinical algorithms highly complex processes such as the management of the severely injured patient can be translated into a clearly structured, logical pathway. ⋯ The use of algorithms allows a systematic search for errors in the process of quality management. In emergency situations they suggest a structured way of problem-solving to the less experienced user. Algorithms are useful instruments in teaching medical decision-making.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Does rationing of intensive care beds lead to premature ward return with preventable complications?].
Readmission to the surgical intensive care unit was necessary in 105 of 2269 patients (4.6%) who were discharged between 1991 and 1995. Mortality was 20% Cardiopulmonary reasons during the first 72 h after initial discharge were rare [33 patients (1.4%)].