Articles: critical-care.
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The risk of bacterial contamination related to epidural analgesia in patients cared for in the intensive care unit has not been assessed. Thus the authors studied patients who received care in the intensive care unit who were given epidural analgesia for more than 48 h to determine the rates of local, epidural catheter, and spinal space infection and to identify risk factors. ⋯ The risk of epidural analgesia-related infection in patients in the intensive care unit seems to be low. The presence of two local signs of inflammation is a strong predictor of local and epidural catheter infection.
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The complex anaesthesia and intensive care of liver transplantation require special instruments beside expert's knowledge. We monitorize the haemodynamics invasively during the operation and immediately afterward. In the later period of intensive care we prefer the noninvasive haemodynamic monitoring techniques. ⋯ To reduce the blood requirements during the operation we use the autotransfusion techniques. During the anaesthesia of the liver transplantation we use other equipment that belong to the everyday work of an anaesthesiologist i.e.: rapid blood infusion and patient warming and cooling systems, rapid laboratory and blood-gas analyzing methods. The anaesthesia and intensive care of liver transplantation claim wideranging knowledge of anaesthesiologist not only theoretically but also practically.
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Sedation is a technique widely used in intensive care unit patients. The main objective is to ensure a proper level of analgesia and the best physical and psychical comfort possible. ⋯ Drugs used for sedation are combinations of opioids (fentanyl or sufentanil), benzodiazepines (midazolam) and hypnotic drugs such as propofol. In combination with the pharmacological approach, a psychological approach is of greater interest in conscious patients.
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Intensive care medicine · Oct 1996
Validation of a quality of life questionnaire for critically ill patients.
Development and validation of quality of life questionnaire for critical care patients. ⋯ Questionnaire meets objectives recommended for critical care use, and fulfills essential requirements of validity and reproducibility when applied to critically ill patients.
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Direct cerebral monitoring is not yet in routine use in the intensive care unit or the operating theatre, despite the brain's sensitivity to ischaemia, and the potentially devastating consequences. Instead, reliance is placed upon indirect indicators such as general physiological parameters and observation of reflexes such as pupillary size and reaction to light. ⋯ However, modern methods of processing and integrating data, (electroencephalographic/evoked potentials, haemodynamic and oxygen measures) together with the availability of powerful, robust microprocessors may well facilitate the development of on-line systems which can warn of cerebral deterioration. These would be of particular value in critically ill patients, and those at risk during or after operative procedures such as neurosurgery, cardiopulmonary bypass and carotid endarterectomy.