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
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 Clinical TrialIntravenous sildenafil and inhaled nitric oxide: a randomised trial in infants after cardiac surgery.
To investigate the acute effects of intravenous sildenafil on haemodynamics and oxygenation, and its interaction with inhaled nitric oxide (iNO) in infants at risk of pulmonary hypertension early after cardiac surgery. ⋯ Intravenous sildenafil augmented the pulmonary vasodilator effects of iNO in infants early after cardiac surgery. However, sildenafil produced systemic hypotension and impaired oxygenation, which was not improved by iNO.
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Intensive care medicine · Nov 2003
Randomized Controlled Trial Clinical TrialIntra-abdominal pressure may be decreased non-invasively by continuous negative extra-abdominal pressure (NEXAP).
To investigate the possibility of artificially decreasing intra-abdominal pressure (IAP) by applying continuous negative pressure around the abdomen. ⋯ Negative extra-abdominal pressure may be applied in critically ill patients to decrease intra-abdominal pressure non-invasively.