Intensive care medicine
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Intensive care medicine · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of two methods to perform a breathing trial before extubation in pediatric intensive care patients.
To compare the percentage of infants and children successfully extubated after a trial of breathing performed with either pressure support or T-piece. ⋯ In infants and children mechanically ventilated, successful extubation was achieved equally effectively after a first breathing trial performed with pressure support of 10 cmH2O or a T-piece.
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Intensive care medicine · Oct 2001
Non-invasive pressure support ventilation in patients with acute respiratory failure after bilateral lung transplantation.
To evaluate non-invasive ventilation (NIV) prospectively in a group of patients developing acute respiratory failure (ARF) after bilateral lung transplantation (BLT). ⋯ NIV administration was well tolerated and avoided intubation in the large majority of patients (86%); in NIV responders the rate of complications was low and ICU mortality nil. NIV should be considered as an interesting alternative to conventional ventilation in patients who require ventilatory support after BLT.
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Intensive care medicine · Oct 2001
Case ReportsMassive pulmonary embolism with large floating thrombus in the truncus of the pulmonary artery.
A conservative strategy with anticoagulation led to spontaneous dissolution of a large floating thrombus (7.0x0.5 cm) in the truncus of the pulmonary artery in a 51-year-old woman with massive pulmonary embolism (pulmonary emboli in both lungs down to the level of the segmental arteries). Interventional therapy such as thrombolysis or pulmonary thrombectomy was not considered to be appropriate for this patient because of the risk of disrupture and embolization of parts of this large central thrombus. We believe that in certain cases with massive pulmonary embolism and large floating central thrombi a conservative strategy with anticoagulation may be appropriate. Such cases may be observed more often in the future using the technique of spiral computed tomographic angiography.
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Intensive care medicine · Oct 2001
Randomized Controlled Trial Multicenter Study Clinical TrialA multi-centre, double-blind, placebo-controlled study of liposomal prostaglandin E1 (TLC C-53) in patients with acute respiratory distress syndrome.
To evaluate the safety of liposomal PGE1 (TLC C-53) in patients with acute respiratory distress syndrome (ARDS), and determine its efficacy in improving oxygenation and reducing ventilator dependency. ⋯ TLC C-53 was generally well-tolerated but failed to reduce mortality or duration of mechanical ventilation.