Intensive care medicine
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Intensive care medicine · Apr 1997
Randomized Controlled Trial Clinical TrialUse of 2% propofol to produce diurnal sedation in critically ill patients.
The assessment of propofol to produce diurnal sedation in critically ill patients. ⋯ Propofol can safely provide diurnal sedation in the critically ill when titrated against the Ramsay score. Sedation levels cannot be manipulated in some severely ill patients.
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Intensive care medicine · Apr 1997
Randomized Controlled Trial Clinical TrialUnfavorable mechanical effects of heat and moisture exchangers in ventilated patients.
To investigate the mechanical effects of artificial noses. ⋯ The artificial noses cause unfavorable mechanical effects by increasing inspiratory resistance, ventilation requirements, and dynamic intrinsic PEEP. Clinicians should consider these effects when setting mechanical ventilation and when assessing patients' ability to breathe spontaneously.
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Intensive care medicine · Apr 1997
Relation of echocardiographic preload indices to stroke volume in critically ill patients with normal and low cardiac index.
To examine the usefulness of preload indices obtained by transoesophageal echocardiography (TOE) for estimating stroke volume at various levels of cardiac index. ⋯ Stability of the relation between echocardiographic preload indices and stroke volume emphasize the potential of TOE for continuous preload monitoring in the critically ill.
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Altered platelet function plays a role in the pathophysiology of multiple organ failure in sepsis. The purpose of the present study was to evaluate various aspects of platelet adhesive function in septic patients and its putative relevance for prognosis. ⋯ In septic patients platelets become activated and are hyperadhesive to other vascular cells including neutrophils and endothelium. This may induce sequestration of platelets and microcirculatory arrest, thus the development of MODS.
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Intensive care medicine · Apr 1997
Reliability of anion gap as an indicator of blood lactate in critically ill patients.
To evaluate the sensitivity, specificity, and predictive values of an elevated anion gap as an indicator of hyperlactatemia and to assess the contribution of blood lactate to the serum anion gap in critically ill patients. ⋯ An elevated anion gap is not a sensitive indicator of moderate hyperlactatemia, but it is quite specific, provided the other main causes of the elevated anion gap have been eliminated. Changes in blood lactate only account for about half of the changes in anion gap, and serum chloride does not seem to be an important factor in the determination of the serum anion gap.