Intensive care medicine
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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
Survival and recovery of consciousness in anoxic-ischemic coma after cardiopulmonary resuscitation.
In patients who remain unconscious after cardiopulmonary resuscitation (CPR) poor outcome may be predicted with several tests. To use these tests, knowledge of a priori chances of poor outcome after varying periods of unconsciousness is needed. This study is aimed at providing such data. ⋯ The a priori chances of (poor) outcome vary with the duration of unconsciousness after CPR. This study provides data for different time-intervals after CPR.
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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
Acute community-acquired bacterial meningitis in adults admitted to the intensive care unit: clinical manifestations, management and prognostic factors.
To study the clinical features, management and prognostic factors associated with adverse clinical outcome in a series of patients with acute community-acquired bacterial meningitis admitted to the intensive care unit (ICU). ⋯ In adult patients with acute community-acquired bacterial meningitis admitted to the ICU, the overall severity of the disease within 24 h of admission may be the major indicator of adverse in-hospital clinical outcome.
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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.