Intensive care medicine
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Intensive care medicine · Jun 1999
Randomized Controlled Trial Clinical TrialThe prognostic significance of passing a daily screen of weaning parameters.
While "weaning parameters" are commonly used to guide removal of mechanical ventilation devices, little information exists concerning their prognostic value. We evaluated whether passing weaning parameters was associated with survival. ⋯ Passing a daily screen of weaning parameters is an independent predictor of successful extubation and survival, but its prognostic value decreases over time. Time spent on mechanical ventilation after passing the daily screen presents an important opportunity to optimize liberation from the ventilator.
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Intensive care medicine · May 1999
Randomized Controlled Trial Multicenter Study Clinical TrialTrial of dexamethasone treatment for severe bacterial meningitis in adults. Adult Meningitis Steroid Group.
To evaluate the clinical benefit of early adjunctive dexamethasone therapy for severe bacterial meningitis in adults. ⋯ Bacterial meningitis is still a severe disease in adults, since the overall observed rate of death or severe neurologic sequelae was 26.7%. The reported data are inconclusive regarding a systematic use of dexamethasone as an adjunctive therapy for bacterial meningitis in adults. Moreover this treatment impairs antibiotic penetration into the cerebrospinal fluid (CSF) that can lead to therapeutic failure, particularly in areas with high or increasing rates of penicillin-resistant S. pneumoniae.
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Intensive care medicine · May 1999
Randomized Controlled Trial Clinical TrialAdditional inspiratory work of breathing imposed by tracheostomy tubes and non-ideal ventilator properties in critically ill patients.
To determine the tracheostomy tube-related additional work of breathing (WOBadd) in critically ill patients and to show its reduction by different ventilatory modes. ⋯ The results indicate that, depending on respiratory flow rate, (1) tracheostomy tubes can cause a considerable amount of WOBadd, and (2) ATC, in contrast to IPS, is a suitable mode to compensate for WOBadd at any ventilatory effort of the patient.
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Intensive care medicine · Apr 1999
Randomized Controlled Trial Clinical TrialFatty acid composition of platelet membrane lipids after administration of two different fat emulsions in critically ill patients.
To determine the effects on platelet membrane fatty acid composition following administration of two different fat emulsions. ⋯ The observed changes in fatty acid composition are in agreement with the lipid composition of the fat emulsions used. Because the C18:2n-6/C18:3n-3 ratio in both emulsions is close (approximately 9.0), the observed changes in the fatty acid composition of platelets may not be relevant for platelet function.
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Intensive care medicine · Feb 1999
Randomized Controlled Trial Comparative Study Clinical TrialContinuous thermodilution cardiac output: clinical validation against a reference technique of known accuracy.
To evaluate the accuracy and precision of continuous thermodilution (CCO) by using a validated bolus thermodilution (BCO) reference technique as criterion standard. ⋯ Decreased precision of CCO as compared to iced BCO may, in clinical settings, be outweighed by the advantages of automated and continuous monitoring. Under research conditions, however, iced BCO remains the method of choice.