Intensive care medicine
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Intensive care medicine · Dec 2007
Monitoring brain tissue oxygen tension in brain-injured patients reveals hypoxic episodes in normal-appearing and in peri-focal tissue.
We compared brain tissue oxygen tension (PtiO2) measured in peri-focal and in normal-appearing brain parenchyma on computerized tomography (CT) in patients following traumatic brain injury (TBI). ⋯ Multiple episodes of brain hypoxia occurred over the first 5 days following severe TBI. PtiO2 was lower in peri-contusional tissue than in normal-appearing tissue. In peri-contusional tissue, a progressive increase of PtiO2 from pathologic to normal values was observed over time, suggestive of an improvement at microcirculatory level.
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Intensive care medicine · Dec 2007
Multicenter StudyPro-atrial natriuretic peptide and pro-vasopressin to predict severity and prognosis in community-acquired pneumonia: results from the German competence network CAPNETZ.
Community acquired pneumonia (CAP) is the most important clinical infection. Therefore, the CAP competence network CAPNETZ was instituted in Germany. The aim of this substudy was to evaluate the value of pro-atrial natriuretic peptide (MR-proANP) and pro-vasopressin (CT-proAVP) for severity assessment and outcome prediction in CAP. ⋯ MR-proANP and CT-proAVP are useful new biomarkers for the risk stratification of CAP patients. They are significantly lower in CAP survivors and correlate with the severity of the disease measured by CRB-65 score.
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Intensive care medicine · Dec 2007
Clinical TrialLimitations of computed tomographic angiography in the diagnosis of brain death.
To evaluate the accuracy of cerebral computed tomographic angiography (CT-a) for the diagnosis of brain death (BD). ⋯ In clinically BD patients with no electroencephalographic activity CT-a documents opacification of the intracerebral vessels in a significant percentage of the cases. Therefore CT-a cannot be recommended as a means of BD diagnosis.
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Intensive care medicine · Dec 2007
Effect of blood pressure on plasma volume loss in the rat under increased permeability.
To evaluate the effects of change in blood pressure on plasma volume under increased permeability. ⋯ Increase in blood pressure by noradrenalin induces loss of plasma volume, which is much greater under increased than under normal permeability and less pronounced in hypovolemia. According to the two-pore theory of transvascular fluid exchange, the loss may be explained by increased hydrostatic capillary pressure.
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Intensive care medicine · Dec 2007
Randomized Controlled Trial Multicenter StudyStrict versus moderate glucose control after resuscitation from ventricular fibrillation.
Elevated blood glucose is associated with poor outcome in patients resuscitated from out-of-hospital cardiac arrest (OHCA). Our aim was to determine whether strict glucose control with intensive insulin treatment improves outcome of OHCA patients. ⋯ We found no additional survival benefit from strict glucose control compared with moderate glucose control with a target between 6 and 8 mmol/l in OHCA patients.