Intensive care medicine
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Intensive care medicine · Jul 2005
Review Meta AnalysisImpact of selective decontamination of the digestive tract on fungal carriage and infection: systematic review of randomized controlled trials.
To determine the impact of the antifungal component of selective decontamination of the digestive tract on fungal carriage, infection and fungaemia. ⋯ Antifungals, as part of selective decontamination of the digestive tract, reduce fungal carriage and infection but not fungaemia in critically ill patients and may justify the inclusion of an antifungal component in the decontamination protocol.
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Intensive care medicine · Jul 2005
Multicenter StudyMulticenter study of the multiple organ dysfunction syndrome in intensive care units: the usefulness of Sequential Organ Failure Assessment scores in decision making.
This study examined the incidence and mortality of multiple organ dysfunction syndrome (MODS) in intensive care units, evaluated the limitation of life support in these patients, and determined whether daily measurement of the Sequential Organ Failure Assessment (SOFA) is useful for decision making. ⋯ This model showed that in our population with MODS those older than 60 years and with SOFA score higher than 9 for at least 5 days were unlikely to survive.
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Intensive care medicine · Jul 2005
Case ReportsExtending the limits of extracorporeal membrane oxygenation: lung rest for a child with non-specific interstitial pneumonia.
Veno-venous extracorporeal membrane oxygenation (ECMO) is an established therapy for the treatment of respiratory failure. Traditionally ECMO has been used to support patients with an acute, reversible disease process, with a predictable outcome. We report the successful use of veno-venous ECMO for an unusual indication. ⋯ ECMO was safely and successfully used to provide a period of lung rest and time for medical therapy to take effect in a child with an unusual indication for support: a rare disease with an uncertain outcome on the background of prolonged mechanical ventilation.
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Intensive care medicine · Jul 2005
Ventilator settings as a risk factor for acute respiratory distress syndrome in mechanically ventilated patients.
A single-center retrospective study initial recently identified ventilator settings as a major risk factor for the development of acute respiratory distress syndrome (ARDS) in mechanically ventilated patients who do not have ARDS from the outset. We tested this hypothesis in a larger sample of patients prospectively enrolled in a multicenter study on mechanical ventilation. ⋯ The association with the potentially injurious initial ventilator settings, in particular large tidal volumes, suggests that ARDS in mechanically ventilated patients is in part a preventable complication. This hypothesis needs to be tested in a prospective study.
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Intensive care medicine · Jul 2005
Facial side effects during noninvasive positive pressure ventilation in children.
The study quantified the side effects of nasal masks use for noninvasive positive pressure ventilation (NPPV) in children. ⋯ The prevalence of facial side effects is clinically significant in children using NPPV. Systematic maxillofacial follow-up enables these effects to be identified. Remedial measures could include the change of the interface or reducing the daily use of NPPV.