Intensive care medicine
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Intensive care medicine · Jan 1988
Lung extravascular volume during venovenous bypass with extracorporeal CO2-removal in dogs.
Extracorporeal circulation can cause lung damage, which would be especially counterproductive during extracorporeal gas exchange for the treatment of acute respiratory failure. To test the hypothesis that partial venovenous bypass with extracorporeal CO2-removal combined with low-frequency positive pressure ventilation (ECCO2R-LFPPV) can adversely affect lung fluid balance, extravascular thermal lung volume (ETV) and hemodynamics were assessed before, during and after ECCO2R-LFPPV in normal closed chest dogs. In series I dogs (n = 6) subjected to 10 h of ECCO2R-LFPPV, ETV did not change significantly from control (7.1 ml/kg +/- 0.99 SE) during or after bypass. ⋯ In series II dogs (n = 5), subjected to shorter periods of ECCO2R-LFPPV, ETV also remained unchanged. In contrast to previous reports using sheep, pulmonary arterial hypertension during bypass was not observed. Thus, ECCO2R-LFPPV was not associated with increased lung water, pulmonary hypertension or morphological lung changes under the conditions studied and does not seem to cause lung damage in normal lungs.
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Intensive care medicine · Jan 1988
Review Retracted PublicationRight ventricular function and cardiac surgery.
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Intensive care medicine · Jan 1988
Mortality and quality of life after intensive care for critical illness.
Early and late mortality of 313 ICU patients and the quality of life of 118 long term ICU survivors was studied to assess the effectiveness of intensive care for critically ill patients. The survival rate at discharge from the ICU was 76%, falling to 61% at 6 months and to 58% at 1 year. A simplified acute physiology score (SAPS) was recorded on ICU admission, as well as age, length of ICU-stay and the number of complications during intensive care. ⋯ In 21% of the patients a deteriorated physical condition was found, 77% remained unchanged and 2% were improved 2 years after ICU discharge, compared to their condition prior to the acute illness. Major functional impairment was found in 38% of the patients. Although the longterm physical condition and functional status correlated with SAPS and age on ICU admission, the best indicator for quality of life after intensive care proved to be the health status prior to the acute illness.
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Intensive care medicine · Jan 1988
Case ReportsIntermittent positive pressure ventilation by nasal mask: technique and applications.
Intermittent positive pressure ventilation delivered non-invasively through a well-fitting nasal mask has been used to control nocturnal hypoventilation in three patients with severe, combined cardiorespiratory and skeletal disease. The advantages of this approach to domiciliary ventilation are described and the requirements of the ventilator are defined.