Intensive care medicine
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Intensive care medicine · Sep 1996
Comparative Study Clinical Trial Controlled Clinical TrialA comparison of the adrenocortical response during septic shock and after complete recovery.
To compare the adrenocortical response to corticotropin during septic shock and after complete recovery. ⋯ Adrenocortical response to corticotropin is attenuated in patients with septic shock and high-output circulatory failure compared to the response in the much less stressful condition after recovery. The attenuated adrenocortical responsiveness may be explained by effects of circulating mediators from the systemic inflammatory response.
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Intensive care medicine · Sep 1996
Effects of positive end-expiratory pressure on right ventricular function in COPD patients during acute ventilatory failure.
To examine the effects of external positive end-expiratory pressure (PEEP) on right ventricular function in chronic obstructive pulmonary disease (COPD) patients with intrinsic PEEP (PEEPi). ⋯ In COPD patients an external PEEP exceeding 90% of PEEPi causes lung hyperinflation and reduces the CI due to a preload effect. The reduction in RVEDVI seems related to changes in EELV, rather than to changes in transmural pressures, suggesting a lung/heart volume interaction in the cardiac fossa. Thus, in COPD patients, application of an external PEEP level lower than PEEPi may affect right ventricular function.
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Intensive care medicine · Sep 1996
Percutaneous dilatational cricothyroidotomy: outcome with 44 consecutive patients.
To assess the value of the percutaneous dilatational technique in elective cricothyroidotomy. ⋯ Percutaneous dilatational cricothyroidotomy can be a quick, safe technique, as good as the percutaneous subcricoidal approach in ventilated, critically ill patients.
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To determine survival and changes in quality of life (QOL) after hospital discharge in patients who had stayed in an intensive care unit (ICU). ⋯ After hospital discharge, the survival of ICU-admitted patients is comparable to that of the general population and not related to ICU treatments. Most patients maintain their physical activity and social status at the preadmission level. Any worsening, if present, is slight and does not influence perceived QOL.
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Intensive care medicine · Sep 1996
Critical illness polyneuropathy in multiple organ dysfunction syndrome and weaning from the ventilator.
Acute axonal polyneuropathy has been found in patients with multiple organ dysfunction syndrome. This 'critical illness polyneuropathy' (CIP) has been associated with difficult weaning from the ventilator in retrospective studies. ⋯ Axonal polyneuropathy is related to the severity of multiple-organ-dysfunction syndrome. Its presence does not necessarily implicate difficult weaning from artificial ventilation.