Intensive care medicine
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Intensive care medicine · Aug 2001
Continuous on-line measurements of respiratory system, lung and chest wall mechanics during mechanic ventilation.
We present a concept of on-line, manoeuvre-free monitoring of respiratory mechanics during dynamic conditions, displaying calculated alveolar pressure/volume curves continuously and separating lung and chest wall mechanics. ⋯ The monitoring concept revealed a constant pattern of successively decreasing compliance within each breath, which became more prominent with increasing PEEP and tidal volume. The monitoring concept offers a simple and reliable method of monitoring respiratory mechanics during ongoing ventilator treatment.
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Intensive care medicine · Aug 2001
Cerebro-splanchnic oxygenation ratio (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischaemia in neonates.
To investigate whether near infrared spectroscopy (NIRS) can detect differences in oxyhaemoglobin signal when applied to the abdomens of neonates with surgically proven splanchnic ischaemia. ⋯ By comparing the TOI of cerebral and splanchnic regions it may be possible to establish the presence of normal splanchnic perfusion and detect when splanchnic ischaemia develops. CSOR had a 90% (56-100%) sensitivity to detect splanchnic ischaemia in neonates. Further work is necessary to confirm these early findings and establish whether abdominal NIRS has a clinical role in detecting splanchnic ischaemia.
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Intensive care medicine · Aug 2001
Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients.
To determine risk factors and clinical consequences of critical illness polyneuropathy (CIP) evaluated by the impact on duration of mechanical ventilation, length of stay and mortality. ⋯ CIP is associated with increased duration of mechanical ventilation and in-hospital mortality. Hyperosmolality, parenteral nutrition, non-depolarizing neuromuscular blockers and neurologic failure can favor CIP development.
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Intensive care medicine · Aug 2001
The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series.
To review all cases of septic shock treated with vasopressin to determine the effects on hemodynamic and renal function and to document any adverse effects. ⋯ In this group of patients with severe septic shock, vasopressin infusion increased MAP and urine output and decreased catecholamine requirements. Doses higher than 0.04 U/min were not associated with increased effectiveness and may have been associated with higher adverse effects.
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Intensive care medicine · Aug 2001
Nosocomial infections during extracorporeal membrane oxygenation.
To examine trends in nosocomial infection associated with Extracorporeal Membrane Oxygenation (ECMO). ⋯ The incidence of infection in ECMO patients at our institution has not increased significantly since our previous study. Cardiac patients have increased risk for nosocomial infection while on ECMO, which may be in part due to longer cannulation times, as well as increased likelihood of undergoing major procedures or having an open chest.