Intensive care medicine
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Intensive care medicine · Sep 2008
Randomized Controlled Trial Multicenter StudyPolymyxin-B hemoperfusion inactivates circulating proapoptotic factors.
To test the hypothesis that extracorporeal therapy with polymyxin B (PMX-B) may prevent Gram-negative sepsis-induced acute renal failure (ARF) by reducing the activity of proapoptotic circulating factors. ⋯ Extracorporeal therapy with PMX-B reduces the proapoptotic activity of the plasma of septic patients on cultured renal cells. These data confirm the role of apoptosis in the development of sepsis-related ARF.
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Intensive care medicine · Sep 2008
Randomized Controlled Trial Comparative StudyShort-term sevoflurane sedation using the Anaesthetic Conserving Device after cardiothoracic surgery.
We evaluated the procedure of postoperative inhalational sedation with sevoflurane using the Anaesthetic Conserving Device (ACD) with regard to recovery times, feasibility and consumption of anaesthetics in comparison to propofol. ⋯ Neurology/sedation, Sedation and anaesthesia.
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Intensive care medicine · Sep 2008
Randomized Controlled TrialSubject-ventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation.
Patient-ventilator synchrony during non-invasive pressure support ventilation with the helmet device is often compromised when conventional pneumatic triggering and cycling-off were used. A possible solution to this shortcoming is to replace the pneumatic triggering with neural triggering and cycling-off-using the diaphragm electrical activity (EA(di)). This signal is insensitive to leaks and to the compliance of the ventilator circuit. ⋯ The present study demonstrates in healthy subjects that subject-ventilator synchrony, trigger effort, and breathing comfort with a helmet interface are considerably less impaired during increasing levels of PSV and respiratory rates with neural triggering and cycling-off, compared to conventional pneumatic triggering and cycling-off.
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Intensive care medicine · Sep 2008
Randomized Controlled TrialA pilot randomized study comparing high and low volume hemofiltration on vasopressor use in septic shock.
High volume hemofiltration (HVHF) has shown potential benefits in septic animals and a few reports suggested a hemodynamic improvement in humans. However, randomized studies are still lacking. Our goal was to evaluate the hemodynamic effects of HVHF in septic shock patients with acute renal failure (ARF). ⋯ HVHF decreased vasopressor requirement and tended to increase urine output in septic shock patients with renal failure. However, a larger trial is required to confirm our results and perhaps to show a benefit in survival.