Intensive care medicine
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Intensive care medicine · Oct 1996
Limitation of life support: frequency and practice in a London and a Cape Town intensive care unit.
To examine the frequency of limiting (withdrawing and withholding) therapy in the intensive care unit (ICU), the grounds for limiting therapy, the people involved in the decisions, the way the decisions are implemented and the patient outcome. ⋯ Withdrawal of therapy occurred commonly, most often because of multiple organ failure. Wide consensus was reached before a decision was made, and the time to death was generally short.
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Intensive care medicine · Oct 1996
Decisions to forego life-sustaining treatment and the duty of documentation.
To study the current practice of documenting decisions to forego life-sustaining treatment in an intensive care unit (ICU), using the Swedish Medical Records Act as a frame of reference. ⋯ The medical records give a fairly accurate picture of the frequency with which such decisions are made at this particular ICU, although the number might be somewhat underestimated. However, the content of the documentation is rather scanty and does not fully satisfy the requirements of the Swedish Medical Records Act. Further studies are needed to warrant any generalization.
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Intensive care medicine · Oct 1996
Randomized Controlled Trial Comparative Study Clinical Trial Retracted PublicationInfluence of different volume therapies on platelet function in the critically ill.
Both albumin and synthetic colloids such as hydroxyethyl starch (HES) solution are used to optimize hemodynamics in the critically ill. The influence of different long-term infusion regimes on platelet function was studied. ⋯ Alterations in hemostasis may occur for several reasons in the critically ill. Human albumin is the preferred first-line volume therapy in patients at risk for coagulation disorders. With respect to platelet function, volume replacement with (lower-priced) low-molecular-weight HES solutions can be recommended in this situation without any risk.
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Intensive care medicine · Sep 1996
Continuous infusion of ketamine in mechanically ventilated children with refractory bronchospasm.
To determine whether ketamine infusion to mechanically ventilated children with refractory bronchospasm is beneficial. ⋯ Continuous infusion of ketamine to mechanically ventilated patients with refractory bronchospasm significantly improves gas exchange and dynamic compliance of the chest.