Critical care medicine
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Critical care medicine · Oct 2003
Editorial CommentHypertonic/hyperoncotic treatment for brain damage.
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Critical care medicine · Oct 2003
Randomized Controlled Trial Clinical TrialUse of xenon as a sedative for patients receiving critical care.
Many sedative regimens are used in the intensive care setting, but none are wholly without adverse effect. Xenon is a noble gas with sedative and analgesic properties. It has been used successfully as a general anesthetic and has many desirable properties, not least of which is a minimal effect on the myocardium. In theory, xenon may provide sedation without adverse effect for certain groups of critically ill patients. The objective of this study was to assess the feasibility of using xenon as an intensive care sedative. ⋯ Xenon provided satisfactory sedation in our group of patients. It was well tolerated with minimal hemodynamic effect. Recovery from this agent is extremely rapid. We have demonstrated the feasibility of using xenon within the critical care setting, without adverse effect.
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Critical care medicine · Oct 2003
Capnometry for noninvasive continuous monitoring of metabolic status in pediatric diabetic ketoacidosis.
To determine the utility of continuous noninvasive capnometry for monitoring pediatric patients with diabetic ketoacidosis as assessed by the agreement between end-tidal carbon dioxide (PetCO2) and PCO2 ⋯ PetCO2 monitoring of patients with diabetic ketoacidosis provides an accurate estimate of PCO2. Noninvasive PetCO2 sampling may be useful in patients with diabetic ketoacidosis to allow for continuous monitoring of patients.
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Critical care medicine · Oct 2003
Decompressive craniectomy for severe traumatic brain injury: Evaluation of the effects at one year.
To assess the effect on outcome (1 yr) of decompressive craniectomy performed within or after the first 24 hrs post-trauma in severely head-injured trauma patients with intractable cerebral hypertension. ⋯ In 40 patients with intractable intracranial hypertension and at very high risk of brain death, decompressive craniectomy allowed 25% of patients to attain social rehabilitation at 1 yr.
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Critical care medicine · Oct 2003
Effect of granulocyte-macrophage colony-stimulating factor on the immune response of circulating monocytes after severe trauma.
Severe injury compromises functions of the antigen-presenting immune cells, resulting in an increased vulnerability toward bacterial sepsis. Support of the immune capabilities contributes a desirable therapeutic option in high-risk patients. Factors possessing immunostimulating properties such as granulocyte-macrophage colony-stimulating factor (GM-CSF) may serve as potential tools to compensate immunosuppression caused by severe trauma. In the present study, therefore, GM-CSF was examined with regard to its capacity to overcome trauma-induced down-regulation of immune functions. ⋯ The presented data show that trauma- and sepsis-induced depression of monocyte functions can be counteracted by GM-CSF in vitro, suggesting that this substance may serve as support of immune functions in severely injured patients.