Intensive care medicine
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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.
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Intensive care medicine · Aug 2006
Randomized Controlled Trial Multicenter Study Comparative StudyEarly enteral immunonutrition vs. parenteral nutrition in critically ill patients without severe sepsis: a randomized clinical trial.
We compared early parenteral nutrition (PN) and early enteral immunonutrition (iEN) in critically ill patients, distinguishing those with and without severe sepsis or septic shock (SS) on admission to intensive care units (ICUs). ⋯ Compared to parenteral nutrition iEN appears to be beneficial in critical patients without severe sepsis or septic shock. Parenteral nutrition in these patients should be abandoned, at least when enteral nutrition can be administered, even at an initial low caloric content.
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Intensive care medicine · Aug 2006
Meta AnalysisQuality of life after acute respiratory distress syndrome: a meta-analysis.
To summarize long-term quality of life (QOL) and the degree of variation in QOL estimates across studies of acute respiratory distress (ARDS) survivors. ⋯ ARDS survivors in different clinical settings experience similar decrements in QOL. The precise magnitude of these decrements helps clarify the long-term prognosis for ARDS survivors.