Intensive care medicine
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Intensive care medicine · Dec 1997
Practice Guideline GuidelineUK guidelines for the use of inhaled nitric oxide therapy in adult ICUs. American-European Consensus Conference on ALI/ARDS.
Although unlicensed, inhaled nitric oxide (NO) therapy is now widely used in the United Kingdom. Our aim was to produce guidelines for the clinical application of inhaled NO in adult intensive care practice, based upon the current level of published information. ⋯ The need for additional quality research to establish evidence of efficacy and safety was emphasized. The guidelines are designed to act within the context of current practice and knowledge and should be revised as further data emerge.
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Intensive care medicine · Dec 1997
Ionized hypocalcemia during out-of-hospital cardiac arrest and cardiopulmonary resuscitation is not due to binding by lactate.
To determine the relationship between ionized calcium concentrations and blood lactate levels during cardiac arrest and cardiopulmonary resuscitation (CPR). ⋯ Ionized hypocalcemia during out-of-hospital cardiac arrest and CPR is not due to binding by both lactate and pyruvate, but may be partly due to complexing by bicarbonate, with some modifications due to variations in pH.
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Intensive care medicine · Dec 1997
Epidemiology of acute renal failure and outcome of haemodiafiltration in intensive care.
To examine the epidemiology of acute renal failure (ARF) and to identify predictors of mortality in patients treated by continuous venovenous haemodiafiltration (CVVHDF). ⋯ General measures of severity are not useful in predicting the outcome of ARF. Only the nature and number of dysfunctioning organ systems and massive transfusion at the beginning of CVVHDF and the age of the patients gave a reliable prognosis in this group of patients.
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Intensive care medicine · Dec 1997
Randomized Controlled Trial Comparative Study Clinical TrialEffects of inhaled salmeterol and salbutamol (albuterol) on morning dips compared in intensive care patients recovering from an acute severe asthma attack.
To assess the effect of a long-acting inhaled beta 2-agonist, salmeterol (SM), compared to a short-acting inhaled beta 2-agonist, salbutamol (or albuterol, SB) on the occurrence of morning dip (MD) in patients recovering from an acute severe asthma attack (ASA). ⋯ MD is frequent in ASA. In ASA, SM appears to reduce the frequency and the severity of MD more than SB. The clinical implications of this observation, particularly a lowering of mortality and a shortening of the ICU stay, remain to be investigated.
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Intensive care medicine · Dec 1997
Randomized Controlled Trial Comparative Study Clinical TrialMidazolam versus propofol for long-term sedation in the ICU: a randomized prospective comparison.
To compare the efficacy, safety, and cost of midazolam and propofol in prolonged sedation of critically ill patients. ⋯ Both drugs afforded reliable, safe, and controllable long-term sedation in ICU patients and rapid weaning from mechanical ventilation. Midazolam depressed respiration, allowed better maintenance of sedation, and yielded complete amnesia at a lower cost, while propofol caused more cardiovascular depression during induction.