Intensive care medicine
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Intensive care medicine · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialEffects of the flow waveform method of triggering and cycling on patient-ventilator interaction during pressure support.
To examine patient-ventilator interaction during pressure support ventilation in critically ill patients when they were ventilated: (1) by a new system (Vision, Respironics) which uses the flow waveform as a method of triggering and cycling; and (2) by a new generation ventilator (Evita 4, Drager) which uses the traditional flow triggering (2 l/min) and cycling criterion (25% of peak flow). ⋯ We conclude that the flow waveform method of triggering improves the ventilator function and decreases the patient effort during the triggering phase. This system is highly sensitive, but under certain circumstances may be unstable.
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Intensive care medicine · Nov 2003
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialEarly antibiotic treatment (prophylaxis) of septic complications in severe acute necrotizing pancreatitis: a prospective, randomized, multicenter study comparing two regimens with imipenem-cilastatin.
We compared two imipenem regimens for prevention of septic complications in patients with severe acute necrotizing pancreatitis (ANP). ⋯ Compared to a 14-day imipenem prophylaxis, a longer antibiotic administration in patients with ANP is not associated with a reduction in the incidence of septic complications of the disease. However, prolonged imipenem administration in patients with persisting systemic complications tends to reduce mortality in ANP compared to a 14-days regimen.
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Intensive care medicine · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative pain in the neonate: age-related differences in morphine requirements and metabolism.
To investigate age-related differences in morphine requirements and metabolism in full-term neonates. ⋯ Neonates aged 7 days or younger require significantly less morphine postoperatively than older neonates. The two morphine regimens (continuous, intermittent) were equally effective and safe. Mechanical ventilation decreases morphine metabolism and clearance.
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Intensive care medicine · Nov 2003
Comparative Study Clinical Trial Controlled Clinical TrialNoninvasive continuous positive airway pressure ventilation using a new helmet interface: a case-control prospective pilot study.
To evaluate the clinical efficacy of noninvasive continuous positive airway pressure ventilation (CPAP) using a new interface, constituted by a cephalic plastic helmet, in comparison with a standard facial mask. ⋯ Despite a high dead-space volume (9-15 l), this new helmet interface is an efficient alternative to standard face mask during CPAP, even in cases of severe respiratory acidosis and hypercapnia. It allowed to provide long-duration CPAP, without any adverse events or clinical intolerance.
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Intensive care medicine · Nov 2003
ReviewAccuracy and repeatability of pediatric cardiac output measurement using Doppler: 20-year review of the literature.
Review of the accuracy and repeatability of Doppler cardiac output (CO) measurements in children. ⋯ The bias, precision, and repeatability from study to study indicate that Doppler CO measurements are acceptably reproducible in children, with best results when used to track changes rather than absolute values, and using the transesophageal approach.