Articles: critical-care.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Propofol versus midazolam. Long-term sedation in the intensive care unit].
Sedative-analgesic treatment of patients on long-term artificial ventilation aims at protection from stress related to their disease or therapy. By stabilising both the patient's vital functions and psychological state this treatment may contribute to therapeutic success. The choice of drugs depends primarily on the nature and course of the underlying disease. ⋯ In both groups this increase was associated with a reduction in peripheral resistance and an increase in rectal temperature. To achieve the desired sedation depth, midazolam was administered at a mean dosage of 0.11 mg/kg.h and propofol at 1.9 mg/kg.h. Catecholamine levels decreased in both groups within the first 8 h: after 8 h of sedation the plasma levels of noradrenaline and adrenaline were 525 and 65 pg/ml, respectively, in the midazolam group and 327 and 51 pg/ml in the propofol group. (ABSTRACT TRUNCATED AT 400 WORDS)
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Intensive Crit Care Nurs · Jun 1992
Continuous monitoring of mixed venous saturation (SvO2): an adjunct to nursing assessment?
Technological advances in oximetry have enabled the development of a pulmonary artery catheter which allows the continuous monitoring of a patient's mixed venous oxygen saturation (SvO2), which is recognised as a valuable indication of cardiac output and the balance between oxygen supply and demand (delivery and consumption). This paper briefly explains the rationale for monitoring SvO2 and highlights possible areas where the data it provides could influence the assessment and implementation of nursing interventions undertaken within intensive care units, and enable those decisions to be made more safely.
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To reduce the very high mortality rate due to septic shock, a new clinical entity has been defined: sepsis syndrome. The aggressive treatment of any sepsis syndrome should prevent the evolution towards a state of shock and thus reduce the risk of a fatal outcome. ⋯ Several pharmacological or immunological interventions--antagonists directed at mediators and multiple cytokines involved in the pathogenesis and perpetuation of sepsis syndrome and septic shock--have been successful experimentally. However, new therapies, such as those using monoclonal antibodies against endotoxins of TNF, cannot yet be considered established.