Intensive care medicine
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We studied 20 unselected patients admitted to our Intensive Care Unit (ICU) suffering from acute respiratory failure (ARF), who needed mechanical ventilatory support. In all of them we followed a prospective protocol to investigate the value of mouth occlusion pressure (P0.1) as an indicator for weaning. Fifty-two tests were classified into three groups: a need to be reconnected to mechanical ventilation (MV), stable on intermittent mandatory ventilation (IMV), or spontaneous breathing on a T-tube (TT). ⋯ Eighty-nine percent (89%) of the times when P0.1 values were higher than 4.2 cm H2O the same patients required ventilatory support, total (MV) or partial (IMV). These differences were statistically significant (p less than 0.01). We conclude that the P0.1 is an easily obtained non-invasive parameter, that can contribute along with other more conventional measurements to a superior indication for weaning.
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Intensive care medicine · Jan 1985
Comparative StudyThe haemostatic effects of hydroxyethyl starch (HES) used as a volume expander.
Hydroxyethyl starch (HES 450.000/0.7; Hespan 6.0 g/100 ml) was compared with standard crystalloid solutions in postoperative volume replacement in 20 patients undergoing routine orthopaedic surgery. The HES group showed no clinical evidence of haemorrhage and no laboratory evidence of significant haemostatic defects as assessed by standard coagulation tests, platelet aggregation and fibrinogen concentrations. There was a slight shortening in the thrombin time and a smaller increase in post-operative FVIII RAg and FVIII RCof levels in the HES group. HES is a safe and effective volume expander for postoperative use.
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Intensive care medicine · Jan 1985
Case ReportsIndomethacin treatment in a patient with lithium-induced polyuria.
Lithium intoxication causes polyuria, central nervous system manifestations, and ultimately stupor progressing to coma. Moreover, polyuria leading to hypernatraemia itself can progress to convulsions and coma. We present a patient with lithium intoxication who remained polyuric, hypernatraemic and somnolent despite normal serum lithium concentrations. After institution of indomethacin orally, polyuria and hypernatraemia disappeared and patient regained consciousness.
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Intensive care medicine · Jan 1985
Outcome and costs of intensive care. A follow-up study on 238 ICU-patients.
A retrospective follow-up study was performed on 238 consecutive admissions in the surgical ICU. The patients were grouped into four categories according to the therapeutic intervention scoring system: 14 in class I, 13 in class II, 81 in class III and 130 in class IV. The mortality rate during their stay in the ICU (5.4%), after discharge from the ICU (2.1%) and 2 years after discharge from the hospital (7.6%) was estimated. ⋯ Fifty-two percent of the total hospitalization costs were generated during the ICU stage which accounted for 17.5% of the hospitalization period. Sixty percent of the total financial investment was spent on the group of survivors who resumed normal work. The mean cost per survivor was $7095 or $1 per survivor per day of active life over an average span of 15 years survival after discharge from the hospital.