Intensive care medicine
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Intensive care medicine · Jan 2009
Randomized Controlled Trial Multicenter StudyIntensive insulin therapy: enhanced Model Predictive Control algorithm versus standard care.
To investigate the effectiveness of an enhanced software Model Predictive Control (eMPC) algorithm for intravenous insulin infusion, targeted at tight glucose control in critically ill patients, over 72 h, in two intensive care units with different management protocols. ⋯ In this feasibility study the eMPC algorithm provided similar, effective and safe tight glucose control over 72 h in critically ill patients in two different ICUs. Further development is required to reduce glucose sampling interval while maintaining a low risk of hypoglycaemia.
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Intensive care medicine · Jan 2009
Randomized Controlled TrialIntensive care unit-acquired neuromyopathy and corticosteroids in survivors of persistent ARDS.
To determine the incidence and outcomes of intensive care unit-acquired neuromyopathy and to investigate the role of methylprednisolone in survivors of persistent acute lung injury. ⋯ ICU-acquired-neuromyopathy is common among survivors of persistent ARDS and is associated with poorer clinical outcomes. We did not find a significant association between methylprednisolone treatment and neuromyopathy. Limitations of this study preclude definitive conclusions about the causal relationship between corticosteroids and ICU-acquired neuromuscular dysfunction.
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Intensive care medicine · Jan 2009
Randomized Controlled TrialIncidence and prognostic value of right ventricular failure in acute respiratory distress syndrome.
To analyse the incidence and the impact on outcome of right ventricular failure (RVF) in patients with acute respiratory distress syndrome (ARDS). ⋯ In this group of patients investigated early in the course of ARDS and ventilated according to a strategy aimed at limiting plateau pressure, the presence of RVF was about 10%. Unlike MPAP and the presence of CVP > PAOP, RVF at this early stage did not appear as an independent factor of mortality.