Intensive care medicine
-
Intensive care medicine · Feb 1999
Randomized Controlled Trial Clinical TrialEffects of early enteral nutrition on intestinal permeability and the development of multiple organ failure after multiple injury.
To determine how immediate enteral nutrition (EN) affects gut permeability and the development of multiple organ failure (MOF) in multiply injured patients. ⋯ In contrast with normal volunteers, the patients started on EN later than 24 h after admission to the ICU demonstrated increased intestinal permeability on the second day after sustaining multiple injury. Also, they had a more severe form of MOF than the group placed on EN immediately upon admission. However, early EN had no influence on the length of ICU stay or the time of mechanical ventilation.
-
Intensive care medicine · Jan 1999
Randomized Controlled Trial Clinical TrialSpontaneous variability of arterial oxygenation in critically ill mechanically ventilated patients.
To assess the magnitude of spontaneous variability of arterial oxygenation and oxygen tension-based indices over time in medical intensive care unit (ICU) patients and to study whether high positive end-expiratory pressure (PEEP) or inverse inspiratory-to-expiratory (I:E) ratio ventilation (IRV) results in a greater variability than low PEEP with conventional I:E ratio ventilation. ⋯ In critically ill medical ICU patients, despite sedation, the spontaneous variability in PaO2 over time is substantial. A high PEEP or IRV does not contribute to the increased variation in PaO2.
-
Intensive care medicine · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized comparison of conventional mechanical ventilation and very early high frequency oscillatory ventilation in extremely premature newborns with respiratory distress syndrome.
To compare the effectiveness and safety of very early high-frequency oscillatory ventilation (HFOV) with conventional mechanical ventilation (CMV) in treatment of the respiratory distress syndrome (RDS) and to evaluate their impact on the incidence of chronic pulmonary disease and early and late morbidity of very low-birthweight neonates. ⋯ HFOV, when applied early and when the clinical strategy of maintenance of optimal lung volume is used, improves oxygenation in the acute stage of RDS, reduces the need of surfactant administration, and can decrease the injury to lung tissue even in extremely immature newborns to whom surfactant is administered therapeutically.
-
Intensive care medicine · Oct 1998
Randomized Controlled Trial Comparative Study Clinical TrialLong chain versus medium chain lipids in patients with ARDS: effects on pulmonary haemodynamics and gas exchange.
To compare pulmonary haemodynamic and gas exchange alterations in septic patients with ARDS receiving long-chain triglycerides (LCT) versus medium-chain triglycerides (MCT). ⋯ In conclusion, we have shown that, in septic patients with respiratory failure, LCT administration was associated with more significant changes of Qva/Qt, MPAP and PaO2/FIO2 compared to infusion of an LCT/MCT 1:1 emulsion. Clinically, these transient alterations might cause serious problems in patients with marginal arterial oxygenation and cardio-respiratory impairment.
-
Intensive care medicine · Sep 1998
Randomized Controlled Trial Clinical TrialGas exchange and pulmonary haemodynamic responses to fat emulsions in acute respiratory distress syndrome.
To investigate the gas exchange and pulmonary haemodynamic responses to two different intravenous fat emulsions in patients with acute respiratory distress syndrome (ARDS). ⋯ The administration of LCT emulsion given at a slow rate did not alter arterial oxygenation because of the beneficial effect of a high cardiac output, hence offsetting the detrimental effect of increased O2 consumption.