Intensive care medicine
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Intensive care medicine · Mar 2007
Is there a safe plateau pressure in ARDS? The right heart only knows.
Airway pressure limitation is now a largely accepted strategy in adult respiratory distress syndrome (ARDS) patients; however, some debate persists about the exact level of plateau pressure which can be safely used. The objective of the present study was to examine if the echocardiographic evaluation of right ventricular function performed in ARDS may help to answer to this question. ⋯ We hypothesize that monitoring of right ventricular function by echocardiography at bedside might help to control the safety of plateau pressure used in ARDS.
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Intensive care medicine · Mar 2007
Clinical TrialPituitary-adrenal responses to human corticotropin-releasing hormone in critically ill patients.
To investigate the pattern of pituitary-adrenal responses to human corticotropin-releasing hormone (hCRH) in critically ill patients and to examine the relation between responses and clinical outcome. ⋯ Critically ill patients demonstrate altered pituitary-adrenal axis responses to hCRH. This is particularly evident in the sickest patients with the highest degree of inflammatory profile who ultimately do not survive.
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Intensive care medicine · Mar 2007
Vascular erosion by central venous catheters used for total parenteral nutrition.
To establish the incidence of central venous catheter erosion in a patient cohort receiving total parenteral nutrition and to examine risk factors and complications of vascular erosion. ⋯ In patients receiving total parenteral nutrition via central venous catheters, erosion has an incidence per catheter of 0.17% and is more likely to occur in left-sided catheters and elderly patients.
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Intensive care medicine · Mar 2007
Dose-related effects of direct hemoperfusion using a cytokine adsorbent column for the treatment of experimental endotoxemia.
To clarify the dose-related effects of direct hemoperfusion using a cytokine adsorbent column (CTR) on the mortality and inflammatory responses to endotoxin-induced shock in rats. ⋯ The present study showed that CTR treatment dose-dependently decreased the mortality rate and inhibited inflammatory responses in vivo.
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Intensive care medicine · Mar 2007
Effect of ornithine alpha-ketoglutarate on glutamine pools in burn injury: evidence of component interaction.
Ornithine alpha-ketoglutarate (OKG) has proved to be efficient in restoring glutamine (Gln) pools which are strongly depleted in hypercatabolic patients. Since its two components, alpha-ketoglutarate (alphaKG) and ornithine (Orn), give rise to glutamate (Glu), they are both considered as Gln precursors. The aim of this study was to assess the relative contributions of Orn and alphaKG to Gln generation in a rat model of burn injury. ⋯ OKG was more efficient than Orn or alphaKG alone in restoring Gln pools in plasma and muscle, which is evidence of metabolic interaction between the two components of this molecule.