Lancet
-
Randomized Controlled Trial Clinical Trial
Pancuronium prevents pneumothoraces in ventilated premature babies who actively expire against positive pressure inflation.
Preterm infants who were making expiratory efforts against ventilator inflation were randomised to be paralysed with pancuronium or to receive no paralysing agent during ventilation. Pneumothoraces developed in all 11 unparalysed babies but in only 1 of 11 (p less than 0.0004) of those managed with pancuronium, which had no serious side-effects. In 34 infants excluded from the trial because they were not breathing against the ventilator, no pneumothoraces developed.
-
Randomized Controlled Trial Clinical Trial
Effect of catheter tunnelling and a nutrition nurse on catheter sepsis during parenteral nutrition. A controlled trial.
In a three-year controlled trial of subcutaneous catheter tunnelling as a method of reducing total parenteral nutrition (TPN) catheter sepsis 99 silicone catheters (52 tunnelled, 47 untunnelled) were inserted into the subclavian (94%) or jugular (6%) veins under aseptic conditions. The influence of a nutrition nurse, who joined the nutrition team after 18 months, on catheter sepsis rate was also documented. Catheter sepsis was confirmed in 13 of 47 (28%) untunnelled catheters and only 6 of 52 (11.5%) tunnelled catheters (p less than 0.05). ⋯ There was no significant difference between tunnelled and untunnelled catheters in sepsis rates after the arrival of the nutrition nurse. Although 85% patients had concurrent internal sepsis, the pathogens implicated in catheter sepsis came from superficial sites in 16 of 19 cases (p less than 0.01). Rigorous aseptic nursing care is thus the most significant factor in the reduction of TPN catheter sepsis, but tunnelling can reduce sepsis rate when nursing care is suboptimum.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Evaluation of the effectiveness of a low sodium diet in the treatment of mild to moderate hypertension.
28 patients who had a sustained diastolic blood pressure of 95 to 104 mm Hg and who had no treatment for it for at least 13 months before the trial, but who were otherwise unselected, took part in a randomised controlled trial in which the effect of a restricted sodium diet was compared with that of a general health package. The general health package did not include any specific hypotensive procedures. ⋯ Within each group both systolic and diastolic blood pressure fell to a highly significant extent after a year, but there was no significant difference between the groups. It would thus seem that the antihypertensive effect of a restricted sodium diet may be related to the increased consultation and monitoring activity of such intervention rather than to the dietary manipulation itself.
-
Letter Randomized Controlled Trial Clinical Trial
"Starch blockers" are ineffective in man.
-
Randomized Controlled Trial Clinical Trial
Double-blind controlled trial of indomethacin as an adjunct to narcotic analgesia after major abdominal surgery.
A prospective randomised trial was undertaken to assess the efficacy of indomethacin as an analgesic after abdominal surgery. 44 patients received indomethacin suppositories (100 mg every 8 h for three days postoperatively) and 46 patients received placebo suppositories (every 8 h for the same period), in addition to intramuscular morphine (0.15 mg/kg every 4 h as required). Postoperative subjective pain assessments, analgesic requirements, and respiratory function were recorded. ⋯ The duration of postoperative morphine requirement was shorter for the indomethacin than for the placebo group. pCO2 on the first postoperative day was lower in the indomethacin group than the placebo group (4.82 +/- 0.08 vs 5.18 +/- 0.08 kPa). The administration of indomethacin in addition to morphine after major abdominal surgery provides better pain control than that provided by intramuscular morphine alone.