Intensive care medicine
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Intensive care medicine · Aug 2006
The effect of normal saline resuscitation on vital organ blood flow in septic sheep.
To study the effect of resuscitation with normal saline on vital organ blood flow and renal function in sepsis. ⋯ In hyperdynamic sepsis resuscitation with normal saline increases central venous pressure, cardiac output, mesenteric blood flow, urine output, creatinine clearance, and fractional excretion of sodium despite a lack of effect on renal blood flow. These effects, however, are transient.
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Intensive care medicine · Aug 2006
Multicenter StudySedation and analgesia in German intensive care units: how is it done in reality? Results of a patient-based survey of analgesia and sedation.
This study carried out the first patient-oriented survey on the practice of analgesia and sedation in German intensive care units, examining whether the goals of early spontaneous breathing and awake, cooperative patients are achieved. ⋯ The choice of agents and techniques for analgesia and sedation in the intensive care unit thus follows the German guidelines. The fact that the patients were more deeply sedated than intended by the therapist in all phases of sedation may be due to the low use of sedation scales and clinical practice guidelines or to the lack of training in using these techniques.
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Intensive care medicine · Aug 2006
Comparative StudySoluble triggering receptor expressed on myeloid cells 1: a biomarker for bacterial meningitis.
To evaluate whether soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in CSF can serve as a biomarker for the presence of bacterial meningitis and outcome in patients with this disease. ⋯ Measuring sTREM-1 in CSF may be a valuable new additional approach to accurately diagnose bacterial meningitis and identify patients at high risk for adverse outcome. Therefore a prospective study of sTREM-1 as a biomarker in bacterial meningitis is needed.
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Intensive care medicine · Aug 2006
Xenon-CT and transcranial Doppler in poor-grade or complicated aneurysmatic subarachnoid hemorrhage patients undergoing aggressive management of intracranial hypertension.
To evaluate whether elevated flow velocimetry values are associated with critically reduced cerebral blood flow values in deeply sedated patients with acute aneurysmatic subarachnoid hemorrhage and in whom the detection of clinical vasospasm is not feasible. ⋯ In patients with elevated intracranial pressure, mean middle cerebral artery flow velocity or Lindegaard Index does not help to detect critical cerebral blood flow nor elevated cerebral blood flow.
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Intensive care medicine · Aug 2006
DTPA Fe(III) decreases cytokines and hypotension but worsens survival with Escherichia coli sepsis in rats.
Nonselective inhibition of nitric oxide (NO) with NO synthase antagonists decreases hypotension but worsens outcome clinically. We investigated whether iron (III) complex of diethylenetriaminepentaacetic acid [DTPA Fe(III)], a scavenger of NO as well as other oxidant mediators, has similar divergent effects in E. coli challenged rats. ⋯ DTPA Fe(III) while increasing blood pressure has the potential to worsen outcome in sepsis. Further preclinical testing is required before this agent is applied clinically.