Intensive care medicine
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Intensive care medicine · Sep 1996
Evaluation of trauma care: validation of the TRISS method in an Italian ICU.
To validate the TRISS method as an audit system on a group of patients with severe trauma admitted to an Italian general intensive care unit (ICU). ⋯ The results of the validation of the TRISS method showed adequate calibration and high discriminatory power in Italian ICU trauma patients also, allowing confidence in the use of this method as an audit tool in our ICU. Some caution is advisable in extending these results to patients with operable intracranial injuries, due to the relatively low number of such cases included in the study.
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Intensive care medicine · Sep 1996
Review Comparative StudyDiagnostic and therapeutic implications of transesophageal echocardiography in medical ICU patients with unexplained shock, hypoxemia, or suspected endocarditis.
To evaluate the diagnostic and therapeutic implications of transesophageal echocardiography (TEE) in intensive care patients. ⋯ TEE is safe and well tolerated and is useful in the management of patients in the intensive care unit with shock, unexplained and severe hypoxemia, or suspected endocarditis when TTE is inconclusive.
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Intensive care medicine · Sep 1996
Randomized Controlled Trial Clinical TrialPostextubation laryngeal edema in adults. Risk factor evaluation and prevention by hydrocortisone.
To evaluate the risk factors for postextubation laryngeal stridor and its prevention by hydrocortisone in adult patients. ⋯ Hydrocortisone did not significantly reduce the incidence of postextubation laryngeal edema or stridor. From the risk factors evaluated, we were unable to demonstrate a statistical correlation between postextubation stidor and the duration of the intubation, the patient's age, the internal diameter of the endotracheal tube, or the route of intubation. However, female patients were more likely to develop this complication.
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Intensive care medicine · Sep 1996
Randomized Controlled Trial Clinical TrialN-acetylcysteine pretreatment of cardiac surgery patients influences plasma neutrophil elastase and neutrophil influx in bronchoalveolar lavage fluid.
Study of leukocyte activation and release of toxic mediators during extracorporeal circulation (ECC). ECC can be used to study the potential protective effect of a pharmacon against neutrophil-mediated lung injury. Clinical studies have indicated that N-acetylcysteine (NAC) may improve systemic oxygenation and reduce the need for ventilatory support when given to patients with acute lung injury. ⋯ Pretreatment with NAC may prevent lung injury by diminishing elastase activity. Since the release of mediators, especially MPO, is not affected, this diminished activity of elastase may be achieved by enhanced inactivation by antiproteases after initial treatment.