Intensive care medicine
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Intensive care medicine · Jul 2011
Randomized Controlled TrialHigh-dose selenium reduces ventilator-associated pneumonia and illness severity in critically ill patients with systemic inflammation.
To confirm the pharmacodynamics and evaluate the efficacy of high-dose selenium (Se) administered by continuous infusion, following an initial loading bolus of selenite, on clinical outcome in critically ill patients with systemic inflammatory response syndrome (SIRS). ⋯ Daily infusion of 1,600 μg Se (as selenite), following an initial bolus of 2,000 μg, is novel and without short-term adverse events. High-dose parenteral selenite significantly increases Se status, improves illness severity, and lowers incidence of hospital-acquired pneumonia including early VAP for SIRS patients in ICU.
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Intensive care medicine · Jul 2011
Randomized Controlled Trial Comparative StudyEarly and late outcome after single step dilatational tracheostomy versus the guide wire dilating forceps technique: a prospective randomized clinical trial.
Percutaneous tracheostomy is frequently performed in long-term ventilated patients in the intensive care unit (ICU). Unfortunately, despite many years of experience, the optimal technique is still unknown, especially considering the occurrence of late complications. The purpose of this study was to determine which of the two most frequently used percutaneous tracheostomy techniques performs best with the emphasis on late complications. ⋯ Compared with the GWDF, the SSDT shows a trend toward less major perioperative complications with a comparable long-term outcome.