Articles: critical-care.
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Randomized Controlled Trial Clinical Trial
[Effect of continuous change in axial position in treatment of post-traumatic lung failure (ARDS). A clinical study].
In the treatment of posttraumatic adult respiratory distress syndrome (ARDS) so far no breakthrough has been achieved. In several cases of severe ARDS we have seen improvements of lung function by means of continuous body positioning. We therefore compared the effect of kinetic positioning (KIN) on lung function and hemodynamics in ARDS patients to conventional (KON) supine positioning. 22 ARDS patients with multiple trauma treated by supportive continuous body positioning (KIN) (KCI-Mediscus) and without continuous positioning (KON) were investigated daily. ⋯ We found no hemodynamic side effects from continuous body positioning. In ARDS-patients submitted to body positioning oxygenation and pulmonary shunt improved significantly and were significantly better compared to those with conventional supine positioning. Continuous body positioning appears to represent a promising supportive treatment regimen in posttraumatic ARDS.
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Transesophageal echocardiography is an important diagnostic tool available to the critical care physician. Indications for the use of transesophageal echocardiography in the intensive care unite include: critical illness and circulatory shock, thoracic aortic dissection, pulmonary embolism and endocarditis. Probe insertion is easy and is successful in 98% of intensive care patients. ⋯ Right ventricular infarction: The transgastric view is usefull in detecting right ventricular wall motion abnormalities and dilatation. Hemodynamically significant right ventricular infarction occurs in the posterior wall, which makes the transesophageal approach ideal. We studied a group of 39 patients with right ventricular infarction.(ABSTRACT TRUNCATED AT 400 WORDS)
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Practice Guideline Guideline
Transporting critically ill patients. American College of Critical Care Medicine, Society of Critical Care Medicine, and American Association of Critical-Care Nurses.
Guidelines for transporting critically ill patients were published simultaneously in the June 1993 issue of Critical Care Medicine (21[6]:931-7) and the May 1993 issue of the American Journal of Critical Care (2[3]:189-95). Developed by a task force composed of members from the American College of Critical Care Medicine, the Society of Critical Care Medicine, and the American Association of Critical-Care Nurses (AACN), these guidelines, summarized below, outline the reasons and requirements for transporting patients, including the personnel who should be involved and the equipment (including monitors) that should accompany the patient. The task force's recommendations are consistent with ECRI's previous recommendations, also summarized below, but are more comprehensive and stringent in some respects and provide additional details.