Critical care medicine
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Critical care medicine · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialRandomized clinical trial of extended use of a hydrophobic condenser humidifier: 1 vs. 7 days.
To determine whether extended use (7 days) would affect the efficiency on heat and water preservation of a hydrophobic condenser humidifier as well as the rate of ventilation-acquired pneumonia, compared with 1 day of use. ⋯ Changing the studied hydrophobic HME after 7 days did not affect efficiency, increase resistance, or altered bacterial colonization. The frequency rate of ventilation-acquired pneumonia was also unchanged. Use of HMEs for > 24 hrs and up to 7 days is safe.
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Critical care medicine · Jan 2002
Randomized Controlled Trial Multicenter Study Clinical TrialRandomized, placebo-controlled trial of lisofylline for early treatment of acute lung injury and acute respiratory distress syndrome.
To determine whether the administration of lisofylline (1-[5R-hydroxyhexyl]-3,7-dimethylxanthine) would decrease mortality in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). ⋯ In this study, there was no evidence that lisofylline had beneficial effects in the treatment of established ALI/ARDS.
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Critical care medicine · Jan 2002
Randomized Controlled Trial Clinical TrialNo effect of preoperative selective gut decontamination on endotoxemia and cytokine activation during cardiopulmonary bypass: a randomized, placebo-controlled study.
Cardiopulmonary bypass predisposes the splanchnic region to inadequate perfusion and increases in gut permeability. Related to these changes, circulating endotoxin has been shown to rise during cardiac surgery, and may contribute to cytokine activation, high oxygen consumption, and fever ("postperfusion syndrome"). To a large extent, free endotoxin in the gut is a product of the proliferation of aerobic gram-negative bacteria and may be reduced by nonabsorbable antibiotics. ⋯ SGD effectively reduces the aerobic gram-negative bowel flora in cardiac surgery patients but fails to affect the incidence of perioperative endotoxemia and cytokine activation during cardiopulmonary bypass and the occurrence of a postperfusion syndrome.
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Critical care medicine · Jan 2002
Randomized Controlled Trial Clinical TrialA phase II randomized, controlled trial of continuous hemofiltration in sepsis.
To study the effect of early and continuous venovenous hemofiltration (CVVH) on the plasma concentrations of several humoral mediators of inflammation and subsequent organ dysfunction in septic patients. ⋯ Early use of CVVH at 2 L/hr did not reduce the circulating concentrations of several cytokines and anaphylatoxins associated with septic shock, or the organ dysfunction that followed severe sepsis. CVVH using current technology cannot be recommended as an adjunct to the treatment of septic shock unless severe acute renal failure is present.