Intensive care medicine
-
Intensive care medicine · Mar 2008
Comparative StudyEffect of pressure support ventilation and positive end expiratory pressure on the rapid shallow breathing index in intensive care unit patients.
We compared rapid shallow breathing index (RSBI) values under various ventilatory support settings prior to extubation. ⋯ In the same patient the use of PSV and/or PEEP as low as 5 cmH2O can influence the RSBI. In contrast, changes in FIO2 may have no effect on the RSBI.
-
Intensive care medicine · Mar 2008
Angiotensin-converting enzyme insertion/deletion polymorphism is not associated with susceptibility and outcome in sepsis and acute respiratory distress syndrome.
The insertion/deletion (I/D) of a 289 base pair Alu repeat sequence polymorphism in the angiotensin-converting enzyme gene (ACE) has been shown to predict susceptibility and outcome in the acute respiratory distress syndrome (ARDS). We hypothesized that the I/D polymorphism also confers susceptibility to sepsis and is a predisposing factor for morbidity and mortality of patients with severe sepsis. ⋯ Our data do not support an association of the ACE gene I/D polymorphism with susceptibility or mortality in severe sepsis or with sepsis-induced ARDS in Spanish patients.
-
Intensive care medicine · Mar 2008
Comparative StudyThe effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness.
To evaluate the effects of sedation with morphine and midazolam (M&M) versus propofol on gastric emptying in critically ill patients. ⋯ In critical illness, patients receiving M&M for sedation are more likely to have slow gastric emptying, and proximal meal retention than those receiving propofol. The apparent beneficial effects of propofol-based sedation need confirmation by a prospective randomised controlled study.
-
Intensive care medicine · Mar 2008
Spontaneous breathing during airway pressure release ventilation in experimental lung injury: effects on hepatic blood flow.
Positive pressure ventilation can affect systemic haemodynamics and regional blood flow distribution with negative effects on hepatic blood flow. We hypothesized that spontaneous breathing (SB) with airway pressure release ventilation (APRV) provides better systemic and hepatic blood flow than APRV without SB. ⋯ Maintaining SB during APRV was associated with better systemic and pre-portal organ blood flow. Improvement in hepatic arterial blood flow was not significant.
-
Intensive care medicine · Mar 2008
The influence of corticosteroids on the release of novel biomarkers in human endotoxemia.
Sepsis intervention studies need better patient stratification methods, and one way to realize this is the introduction of stable biomarkers. A set of recently developed novel biomarkers, based upon precursor-fragments of short-lived hormones, was previously shown to be increased during sepsis. However, it is not known whether these biomarkers are influenced by sepsis intervention strategies. Therefore we investigated the markers in a model of human endotoxemia intervened by increasing doses of prednisolone. ⋯ These results show that a set of novel, highly stable sepsis biomarkers was increased during human endotoxemia and was dose-dependently inhibited by corticosteroid pre-treatment.