Articles: critical-care.
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Intensive care medicine · Jan 1990
Randomized Controlled Trial Clinical TrialPlasma catecholamine concentration during sedation in ventilated patients requiring intensive therapy.
The effects of isoflurane and midazolam sedation on the catecholamine responses of ventilated patients were studied over a 24-h period. Sixty ventilated patients admitted to our intensive therapy unit were allocated randomly to receive either isoflurane or midazolam sedation. ⋯ Patients sedated with midazolam showed no significant changes of adrenaline or noradrenaline concentrations. Overall, a more satisfactory degree of sedation was achieved with isoflurane.
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Intensive care medicine · Jan 1990
European attitudes towards ethical problems in intensive care medicine: results of an ethical questionnaire.
A questionnaire was sent to the 590 members of the European Society of Intensive Care Medicine to define both the current practices and the opinions of these specialists on various ethical issues. The answers from 242 (41%) European members were collected and analysed. The first part of the questionnaire was designed to define the criteria for admission to Intensive Care throughout Europe. ⋯ Only 24 (10%) of the respondents stated that they always delivered complete information to their patients and only 31 (13%) thought they should do so. When an iatrogenic incident occurred, only 39 (16%) claimed to relate exactly what had happened, to the patient or their relatives but 121 (50%) thought they should. Informed consent was usually required for surgery or gastroscopy and the administration of a new medication.
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Critical care clinics · Jan 1990
ReviewTrauma anesthesia and critical care: the concept and rationale for a new subspecialty.
Proper care of the severely injured patient will require the development of a new anesthesia specialist. The trauma anesthesiologist, like the cardiovascular anesthesiologist, must become thoroughly familiar with one disease. The anesthesiologist who manages patients with traumatic disease must become an expert in critical care, high-risk anesthesia practice, and emergency resuscitation of the trauma patient. An outline for a fellowship in trauma anesthesia and critical care is included.
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Intensive care medicine · Jan 1990
Comparative Study Clinical TrialOptimal oxygen delivery in critically ill patients.
Standard hemodynamic support in septic shock is to increase pulmonary capillary wedge pressure to above 15 mmHg by volume replacement and to give inotropic support if the mean arterial pressure (MAP) is not adequate. In an attempt to decrease mortality in critically ill patients, oxygen delivery (DO2) was increased by switching inotropic support from dobutamine alone or in combination with norepinephrine to dopamine alone, or by adding dopexamine, prostacyclin, or hypertonic saline to the treatment. ⋯ The results indicate that if adequate volume and inotropic support is provided for critically ill patients, the detectable oxygen debt is small and has little effect on patient outcome. When DO2 is adequate, factors other than a tissue oxygen deficit seem to determine patient outcome.