Intensive care medicine
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Intensive care medicine · Dec 1997
Randomized Controlled Trial Comparative Study Clinical TrialEffects of inhaled salmeterol and salbutamol (albuterol) on morning dips compared in intensive care patients recovering from an acute severe asthma attack.
To assess the effect of a long-acting inhaled beta 2-agonist, salmeterol (SM), compared to a short-acting inhaled beta 2-agonist, salbutamol (or albuterol, SB) on the occurrence of morning dip (MD) in patients recovering from an acute severe asthma attack (ASA). ⋯ MD is frequent in ASA. In ASA, SM appears to reduce the frequency and the severity of MD more than SB. The clinical implications of this observation, particularly a lowering of mortality and a shortening of the ICU stay, remain to be investigated.
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Intensive care medicine · Dec 1997
Randomized Controlled Trial Comparative Study Clinical TrialMidazolam versus propofol for long-term sedation in the ICU: a randomized prospective comparison.
To compare the efficacy, safety, and cost of midazolam and propofol in prolonged sedation of critically ill patients. ⋯ Both drugs afforded reliable, safe, and controllable long-term sedation in ICU patients and rapid weaning from mechanical ventilation. Midazolam depressed respiration, allowed better maintenance of sedation, and yielded complete amnesia at a lower cost, while propofol caused more cardiovascular depression during induction.
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Intensive care medicine · Dec 1997
Randomized Controlled Trial Clinical TrialEndogenous endotoxemia of intestinal origin during cardiopulmonary bypass. Role of type of flow and protective effect of selective digestive decontamination.
To evaluate the possible related factors to endotoxemia and cytokine activation during the ischemic phase of extracorporeal surgery, and the effect of selective digestive decontamination (SDD) as a preventive measure. ⋯ SDD reduces the gut content of enterobacteria. This may explain the lower endotoxin and cytokine levels detected in decontaminated patients. In addition to SDD, the type of flow employed during bypass seems to influence endotoxemia and cytokine levels.
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Intensive care medicine · Dec 1997
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialRight ventricular function during weaning from mechanical ventilation after coronary artery bypass grafting: effect of volume loading.
The study was designed to investigate the right ventricular (RV) reaction to weaning from mechanical ventilation (MV) in patients with and without volume loading after coronary artery bypass grafting (CABG). ⋯ An increase in RV volumes with a concomitant increase in RVSWI was observed in high preload patients when going from MV to SV, suggesting a preserved RV function during weaning from MV in this group compared with control patients. The depression in RV contractility observed in some patients suggested that rapid volume expansion before weaning from MV in CABG patients must be done carefully.
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Intensive care medicine · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialRespiratory comfort of automatic tube compensation and inspiratory pressure support in conscious humans.
To compare the new mode of ventilatory support, which we call automatic tube compensation (ATC), with inspiratory pressure support (IPS) with respect to perception of respiratory comfort. ATC unloads the resistance of the endotracheal tube (ETT) in inspiration by increasing the airway pressure, and in expiration by decreasing the airway pressure according to the non-linear pressure-flow relationship of the ETT. ⋯ ATC provides an increase in respiratory comfort compared with IPS. The predominant cause for respiratory discomfort in the IPS mode seems to be lung over-inflation.