Intensive care medicine
-
Intensive care medicine · Feb 2002
Airway obstruction and ventilator dependency in young children with congenital cardiac defects: a role for self-expanding metal stents.
Young children with congenital cardiac defect and airway obstruction leading to ventilator dependency present a significant clinical challenge with uncertain outcome. ⋯ Airway stenting in such young children is an infrequent procedure often undertaken in dire circumstances. We have found it valuable in enabling ventilator-dependent children to be extubated with encouraging early results. Their long-term outlook remains uncertain and is dependent on the underlying cardiac status.
-
Intensive care medicine · Feb 2002
Randomized Controlled Trial Comparative Study Clinical TrialImpact of sepsis, lung injury, and the role of lipid infusion on circulating prostacyclin and thromboxane A(2).
To investigate whether plasma levels of prostacyclin (PGI2) and thromboxane A(2) (TxA2) are a function of the infusion rate of soybean-based fat emulsions, severity of systemic inflammation, and pulmonary organ failure. ⋯ The quantity of prostanoids formed and their subsequent utilization are dependent on the availability of precursor linoleic acid and are probably affected by the severity of SIRS or sepsis and the existence of pulmonary organ failure, respectively. Because TxA2 might be extracted by the injured lung, rapid infusion of soybean-based fat emulsions should be avoided in patients suffering from severe pulmonary organ failure.
-
Intensive care medicine · Feb 2002
Comparative StudyScoring systems in pediatric intensive care: PRISM III versus PIM.
To compare the performance of two different clinical scoring systems that were developed to assess mortality probability in pediatric intensive care. ⋯ PRISM III and PIM scores are both adequate indicators of mortality probability for heterogeneous patient groups in pediatric intensive care. Possibly in larger studies (equivalence trial) a significant and relevant difference between these scores would be demonstrated.
-
Intensive care medicine · Feb 2002
Bispectral index variations during tracheal suction in mechanically ventilated critically ill patients: effect of an alfentanil bolus.
To evaluate the impact of an alfentanil dose on bispectral index (BIS) variations during tracheal suction in ICU sedated patients. ⋯ An alfentanil bolus of 15 microg/kg markedly reduced the increase in BIS values, blood pressure, and heart rate observed immediately after tracheal suction. Therefore BIS monitoring in ICU may help to improve analgesia during invasive events.
-
Intensive care medicine · Feb 2002
Is the bispectral index appropriate for monitoring the sedation level of mechanically ventilated surgical ICU patients?
To determine the value of the bispectral index (BIS) in assessing the depth of sedation in sedated and mechanically ventilated ICU patients, compared with clinical sedation scores. ⋯ BIS is correlated only in some ICU patients with the clinical assessment of their sedation level as based on various scores. At deeper sedation levels the interindividual differences increase. There were no criteria found to distinguish patients with and without correlation. This suggests that the BIS is not suitable for monitoring the sedation in a heterogeneous group of surgical ICU patients.