Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialThe management of pneumothorax with the thoracic vent versus conventional intercostal tube drainage.
The thoracic vent is a new minimally invasive device for the treatment of spontaneous and iatrogenic pneumothorax. It consists of a polyurethane catheter connected to a plastic chamber containing a one-way valve. As there is no need to connect the thoracic vent to an underwater seal device, immobilization and hospitalization can be avoided. ⋯ Hence, we have performed a randomized study comparing the treatment of pneumothorax by means of the thoracic vent versus conventional intercostal tube drainage in 30 patients, including some with tension pneumothorax. 17 patients were treated with the thoracic vent, 13 with conventional intercostal tube drainage. We found no significant differences in the rate of reexpansion and rate of complications between the group treated with the thoracic vent and the group treated with intercostal tube drainage, but the patients treated with the thoracic vent needed significantly less analgesics. 70% of the patients treated with the thoracic vent were successfully managed on an outpatient basis. All patients treated with intercostal tube drainage were hospitalised; duration of inpatient-therapy was 8 +/- 6.2 days (mean +/- SD).
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Wien. Klin. Wochenschr. · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialSafety and efficacy of increasing dosages of glycyl-glutamine for total parenteral nutrition in polytrauma patients.
Supplementation of parenteral nutrition with glutamine (GLN) has been suggested to improve the efficacy of nutritional support by stimulating protein synthesis and improving immunocompetence. In the present study we investigated the impact of infusing the dipeptide glycyl-glutamine (GLY-GLN) at increasing dosages on plasma amino acid concentrations in patients with polytrauma. Nine polytraumatized patients were randomly assigned according their age and their trauma score to three experimental groups. ⋯ We conclude from this first available dose finding study on glutamine-containing dipeptides that in polytraumatized patients infusion of 570 mg/kg/day of GLY-GLN (corresponding to 28 g glutamine or 40 g dipeptide/70 kg, respectively) is necessary to induce a sustained effect on plasma glutamine concentrations. No pathological accumulation of free glycine or of the dipeptide was seen with any of the three dosage steps of GLY-GLN. Thus, the administration of even high doses of GLY-GLN is feasible and safe in patients with polytrauma and is not associated with any relevant renal substrate loss.