Intensive care medicine
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Intensive care medicine · Apr 1996
Randomized Controlled Trial Comparative Study Clinical Trial Retracted PublicationThe effects of pentoxifylline on circulating adhesion molecules in critically ill patients with acute renal failure treated by continuous veno-venous hemofiltration.
Circulating adhesion molecules appear to be excellent markers of endothelial activation in critically ill patients. Pentoxifylline (PTX) may limit sequelae of inflammation and subsequent endothelial activation by various mechanisms. The influence of PTX on the plasma levels of soluble adhesion molecules in critically ill patients undergoing continuous veno-venous hemofiltration (CVVH) was studied. ⋯ Leukocyte/endothelial interactions play an important role in the inflammatory process. Circulating adhesion molecules may serve as markers of the extent of inflammation. Continuous i.v. administration of PTX was successful in blunting the increase of soluble adhesion molecules in critically ill patients undergoing CVVH. Whether these effects result from improved circulation at the microcirculatory level or from (direct or indirect) beneficial effects on endothelial cells warrants further controlled studies.
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Intensive care medicine · Mar 1996
Randomized Controlled Trial Multicenter Study Clinical TrialThe automatic selection of ventilation parameters during the initial phase of mechanical ventilation.
To test a method that allows automatic set-up of the ventilator controls at the onset of ventilation. ⋯ The AutoInit ventilator settings, which were automatically derived, were acceptable for all patients for a period of 20 min and were not found to be inferior to the control ventilator settings. This makes the AutoInit method potentially useful as an automatic start-up procedure for mechanical ventilation.
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Intensive care medicine · Mar 1996
Randomized Controlled Trial Comparative Study Clinical TrialComputed tomography vs clinical and multidisciplinary procedures for early evaluation of severe abdomen and chest trauma--a cost analysis approach.
To compare contrast computed tomography (CT) for evaluating abdominal and vascular chest injuries after emergency room resuscitation with multidisciplinary management based on bedside procedure (BP), e.g., peritoneal lavage, abdomen ultrasonography urography and, if indicated, CT and/or aortography or transesophageal echocardiography. ⋯ This cost-minimization study suggests that CT is a more cost-effective method for the post-emergency room resuscitation evaluation of severe abdominal blunt trauma than the multidisciplinary BP. Chest CT is a screening method for mediastinal hematoma but not for etiology.
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Intensive care medicine · Jan 1996
Randomized Controlled Trial Clinical TrialTransgastric, pulsed Doppler echocardiographic determination of cardiac output.
The aim of this study was to evaluate the accuracy of cardiac output measurement with transesophageal echocardiography (TEE) using a transgastric, pulsed Doppler method in acutely ill patients. ⋯ Transgastric pulsed Doppler measurement across the left ventricular outflow tract with TEE is a very feasible and clinically acceptable method for cardiac output measurement in acutely ill patients.
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Intensive care medicine · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effects of pressure support ventilation delivered by three different ventilators during weaning from mechanical ventilation.
To compare the effects of pressure support ventilation (PSV) delivered at the same level by three different ventilators on patients' work of breathing (WOB), breathing pattern and gas exchange. ⋯ During PSV, the different working principles of different mechanical ventilators profoundly affect patient's WOB. Among the various factors, velocity of pressurization of PSV may play a role in its efficacy in unloading the respiratory muscles.