Intensive care medicine
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Intensive care medicine · Aug 2003
Clinical TrialHLA-DR as a marker for increased risk for systemic inflammation and septic complications after cardiac surgery.
This study investigated the predictive value of a decrease in monocyte HLA-DR expression as an early marker for postoperative SIRS and septic complications. We hypothesized that decreased HLA-DR levels in the first 24 h after cardiac surgery is not related to postoperative SIRS/sepsis. We also compared HLA-DR levels of patients with postoperative complications to those with an uncomplicated course. ⋯ In patients undergoing cardiac surgery the monitoring of pre- and immediate postoperative HLA-DR levels during the first 24 h does not help to predict increased risk for postoperative SIRS/sepsis or infectious complications.
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Intensive care medicine · Aug 2003
Usefulness of procalcitonin for diagnosing complicating sepsis in patients with cardiogenic shock.
Patients in cardiogenic shock (CS) often present with signs of systemic inflammation that mimic infection, especially in the setting of multiple organ failure (MOF). To clarify the usefulness of procalcitonin (PCT) for diagnosing complicating sepsis in patients with CS, especially in the presence of MOF we compared PCT concentrations in patients with CS with and without MOF to those in patients with septic shock (SS). ⋯ PCT concentrations above 2 ng/ml are frequently found in CS patients with MOF and do not necessarily indicate infection. PCT was slightly better than CRP for diagnosing sepsis in our study, but a PCT concentration of 10 ng/ml or higher seems to be more appropriate for diagnosing this complication in CS patients than 2 ng/ml.
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Intensive care medicine · Aug 2003
Clinical TrialAlveolar recruitment of atelectasis under combined high-frequency jet ventilation: a computed tomography study.
To quantify the effect of superimposed high-frequency jet ventilation on lung recruitment in adult patients with acute lung injury. ⋯ Treatment with superimposed high-frequency jet ventilation for 4 h resulted in rapid alveolar recruitment in dependent lung areas, improved gas exchange, and better arterial oxygenation. It offers an effective and advantageous alternative to conventional ventilation for ventilatory management of respiratory insufficient patients.