Critical care medicine
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Critical care medicine · Nov 1999
Randomized Controlled Trial Comparative Study Clinical TrialProspective, randomized, controlled trial to determine the effect of early enhanced enteral nutrition on clinical outcome in mechanically ventilated patients suffering head injury.
To determine the effect of early enhanced enteral nutrition (EN) on clinical outcome of head-injured patients. ⋯ Enhanced EN appears to accelerate neurologic recovery and reduces both the incidence of major complications and postinjury inflammatory responses.
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Critical care medicine · Nov 1999
Randomized Controlled Trial Comparative Study Clinical TrialBeneficial effects of helium:oxygen versus air:oxygen noninvasive pressure support in patients with decompensated chronic obstructive pulmonary disease.
To test the hypothesis that, in decompensated chronic obstructive pulmonary disease (COPD), noninvasive pressure support ventilation using 70:30 helium:oxygen instead of 70:30 air:oxygen could reduce dyspnea and improve ventilatory variables, gas exchange, and hemodynamic tolerance. ⋯ In decompensated COPD patients, noninvasive pressure support ventilation with helium:oxygen reduced dyspnea and PaCO2 more than air:oxygen, modified respiratory cycle times, and did not modify systemic blood pressure. These effects could prove beneficial in COPD patients with severe acute respiratory failure and might reduce the need for endotracheal intubation.
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Critical care medicine · Nov 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialEfficacy of recombinant human erythropoietin in the critically ill patient: a randomized, double-blind, placebo-controlled trial.
To determine whether the administration of recombinant human erythropoietin (rHuEPO) to critically ill patients in the intensive care unit (ICU) would reduce the number of red blood cell (RBC) transfusions required. ⋯ The administration of rHuEPO to critically ill patients is effective in raising their Hct concentrations and in reducing the total number of units of RBCs they require.
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Critical care medicine · Nov 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialThe effect of acidified enteral feeds on gastric colonization in critically ill patients: results of a multicenter randomized trial. Canadian Critical Care Trials Group.
To evaluate the effect of acidified enteral feeds on gastric colonization in critically ill patients compared with a standard feeding formula. ⋯ Acidified enteral feeds preserve gastric acidity and substantially reduce gastric colonization in critically ill patients. Larger studies are needed to examine its effect on ventilator-associated pneumonia and mortality.
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Critical care medicine · Nov 1999
Randomized Controlled Trial Comparative Study Clinical TrialContinuous infusions of lorazepam, midazolam, and propofol for sedation of the critically ill surgery trauma patient: a prospective, randomized comparison.
To compare the efficacy, safety, and cost of continuous infusions of lorazepam, midazolam, and propofol in a critically ill trauma/surgery patient population. ⋯ The data suggest that lorazepam appears to be a cost-effective choice for sedation; however, oversedation may be problematic. Midazolam is the most titratable drug in our population, avoiding excessive oversedation or undersedation. Trauma patients may respond inadequately to propofol even at higher doses. Lorazepam may be the sedative of choice in critically ill trauma/surgery patients.