Intensive care medicine
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Intensive care medicine · Jul 2001
Clinical Trial Controlled Clinical TrialValidity of an abbreviated indirect calorimetry protocol for measurement of resting energy expenditure in mechanically ventilated and spontaneously breathing critically ill patients.
To test a short indirect calorimetry protocol with five stable 1-min readings (5-min steady state) against the commonly used protocol of 30 1-min readings (30-min steady state) in critically ill patients with various modes of ventilation. ⋯ Indirect calorimetry with 5-min steady state test correlated very well with the 30-min steady state test in both mechanically ventilated and spontaneously breathing patients. The time required varies depending on the mode of ventilation, and it is influenced by the level of sedation in mechanically ventilated patients. The abbreviated protocol may be more acceptable to spontaneously breathing patients.
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Intensive care medicine · Jul 2001
Randomized Controlled Trial Multicenter Study Clinical TrialA multicenter, open-label, prospective, randomized, dose-ranging pharmacokinetic study of the anti-TNF-alpha antibody afelimomab in patients with sepsis syndrome.
To investigate the pharmacokinetics and safety of afelimomab, a murine antibody fragment against human tumor necrosis factor (TNF)-alpha in patients with sepsis. ⋯ Multidose therapy with afelimomab was safe, well tolerated, and had predictable linear kinetics. A large randomized trial comparing afelimomab to placebo in patients with well defined sepsis has recently been completed.
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Intensive care medicine · Jul 2001
Dysfunction of vasomotor reactivity in severe sepsis and septic shock.
Perfusion abnormalities are an overall phenomenon in severe sepsis and septic shock, leading to organ dysfunction. We investigated whether carbon dioxide (CO2)-induced vasomotor reactivity (VMR) is impaired in septic patients, compared with values obtained outside sepsis. ⋯ In the advent of a disturbed cerebral autoregulation, critical drops in blood pressure during sepsis are transferred directly into the vascular bed, leading to cerebral hypoperfusion. This mechanism might contribute to the pathogenesis of septic encephalopathy.
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Intensive care medicine · Jul 2001
Clinical TrialHepato-splanchnic metabolic effects of the stable prostacyclin analogue iloprost in patients with septic shock.
To evaluate the effects of the stable prostacyclin analogue iloprost on hepato-splanchnic blood flow, oxygen exchange and metabolism in patients with septic shock. ⋯ In patients with septic shock an iloprost-induced increase in cardiac index increased splanchnic blood flow and shifted oxygen utilization from the energy requiring de novo glucose production rate to other oxygen-demanding metabolic pathways.