Critical care medicine
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Critical care medicine · Mar 2003
Randomized Controlled Trial Clinical TrialEnteral naloxone reduces gastric tube reflux and frequency of pneumonia in critical care patients during opioid analgesia.
Opioid analgesia impairs gastrointestinal motility. Enteral administration of naloxone theoretically allows selective blocking of intestinal opioid receptors caused by extensive presystemic metabolism. Therefore, we studied the effect of enteral naloxone on the amount of gastric tube reflux, the frequency of pneumonia, and the time until first defecation in mechanically ventilated patients with fentanyl analgesia. ⋯ Our results provide evidence that the administration of enteral opioid antagonists in ventilated patients with opioid analgesia might be a simple-and possibly preventive-treatment of increased gastric tube reflux and reduces frequency of pneumonia.
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Critical care medicine · Mar 2003
Randomized Controlled Trial Comparative Study Clinical TrialSafety of sedation with ketamine in severe head injury patients: comparison with sufentanil.
The aim of the study was to compare the safety concerning cerebral hemodynamics of ketamine and sufentanil used for sedation of severe head injury patients, both drugs being used in combination with midazolam. ⋯ The results of this study suggest that ketamine in combination with midazolam is comparable with a combination of midazolam-sufentanil in maintaining intracranial pressure and cerebral perfusion pressure of severe head injury patients placed under controlled mechanical ventilation.
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Critical care medicine · Mar 2003
Comparative Study Clinical Trial Controlled Clinical TrialEffects of sustained inflation and postinflation positive end-expiratory pressure in acute respiratory distress syndrome: focusing on pulmonary and extrapulmonary forms.
To investigate whether the response to sustained inflation and postinflation positive end-expiratory pressure varies between acute respiratory distress syndrome with pulmonary (ARDS(exp)) and extrapulmonary origin (ARDS(exp)). ⋯ Sustained inflation followed by high levels of postinflation positive end-expiratory pressure provided an increase in respiratory system compliance in ARDS; however, arterial oxygenation improved in both ARDS forms.
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Critical care medicine · Mar 2003
Effect of adverse drug reactions on length of stay in surgical intensive care units.
To determine the frequency of adverse drug reactions in surgical intensive care units and evaluate their effect on the length of stay. ⋯ Adverse drug reactions are a significant clinical and economic problem in surgical intensive care units.