Intensive care medicine
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Intensive care medicine · Sep 2006
Case ReportsExtracorporeal life support in a case of acute carbamazepine poisoning with life-threatening refractory myocardial failure.
To report the efficacy of extracorporeal life support (ECLS) in acute carbamazepine poisoning with sustained refractory myocardial failure and a high degree of conductance disturbances. ⋯ We report a case of life-threatening myocardial failure with conductance disturbances secondary to an acute carbamazepine poisoning, demonstrating the efficacy of ECLS to assist recovery.
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Intensive care medicine · Sep 2006
Extravascular lung water to blood volume ratios as measures of permeability in sepsis-induced ALI/ARDS.
We studied the relationship, and the effect of fluid loading on this, between the ratio of extravascular lung water (EVLW) to intrathoracic/pulmonary blood volumes (ITBV, PBV) and the radionuclide pulmonary leak index (PLI) to protein during sepsis-induced acute lung injury/acute respiratory distress syndrome (ALI/ARDS). ⋯ The data demonstrate that EVLW/ITBV or EVLW/PBV are imperfect measures of increased protein permeability in mechanically ventilated patients with sepsis-induced ALI/ARDS particularly when the PLI is severely increased and during pneumonia, independent of fluid status.
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Intensive care medicine · Sep 2006
Body and head position effects on regional lung ventilation in infants: An electrical impedance tomography study.
To determine the effects of body and head positions on the spatial distribution of ventilation in nonintubated spontaneously breathing and mechanically ventilated infants using electrical impedance tomography (EIT). ⋯ The results indicate that the spatial distribution of ventilation is influenced by the body and head position in spontaneously breathing infants. Prone posture with the leftward head rotation has the most prominent effect which is detectable even during mechanical ventilation.
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Intensive care medicine · Sep 2006
Incidence, risk factors, and outcome of aspiration pneumonitis in ICU overdose patients.
To assess the incidence and outcome of clinically significant aspiration pneumonitis in intensive care unit (ICU) overdose patients and to identify its predisposing factors. ⋯ Clinically relevant aspiration pneumonitis is a frequent complication in overdose patients admitted to the ICU. Moreover, aspiration pneumonitis is associated with a higher incidence of cardiac arrest and increased ICU and total in-hospital stay.
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Intensive care medicine · Sep 2006
Physiological responses during a T-piece weaning trial with a deflated tube.
T-piece trials and spontaneous breathing trials through the tracheostomy tube are often used as weaning techniques. They are usually performed with the cuff inflated, which may increase the inspiratory load and/or influence the tidal volume generated by the patient. We assessed diaphragmatic effort during T-piece trials with or without cuff inflation. ⋯ Diaphragmatic effort is significantly lower during a T-piece trial with a deflated cuff than when the cuff is inflated, while RIP-V(T) is higher, so that the diaphragm's efficiency in generating tidal volume is also improved.