Critical care medicine
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Critical care medicine · Sep 2004
Randomized Controlled Trial Clinical TrialEffect of long-term and high-dose antithrombin supplementation on coagulation and fibrinolysis in patients with severe sepsis.
Sepsis is frequently associated with coagulatory activation, which may contribute to deteriorated organ function. Antithrombin is one important endogenous coagulation inhibitor that is therapeutically applied during sepsis. This study investigates the effect of 14-day antithrombin application on coagulatory variables. ⋯ In this first study on long-term antithrombin therapy, antithrombin significantly reduced septic coagulatory response in patients with severe sepsis when given over 14 days.
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Critical care medicine · Sep 2004
Randomized Controlled Trial Clinical TrialSecondary confirmation of endotracheal tube position by ultrasound image.
Secondary confirmation of endotracheal (ET) tube position by ultrasound image. ⋯ Ultrasound imaging of diaphragm motion is a useful, quick, noninvasive, portable, and direct anatomic method for assessment of ET tube position. We think it should be considered the method of choice for the secondary confirmation of the ET tube position.
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Critical care medicine · Sep 2004
Randomized Controlled Trial Comparative Study Clinical TrialMyocardial infarction rate in acute pulmonary edema: noninvasive pressure support ventilation versus continuous positive airway pressure.
Noninvasive pressure support ventilation (NIPSV) delivered by face mask has proved an effective treatment for patients with acute pulmonary edema. However, an increase in acute myocardial infarction rate has been reported with this ventilation modality. We investigated whether the use of NIPSV increases the incidence of acute myocardial infarction compared with continuous positive airway pressure (CPAP) in patients with acute pulmonary edema. ⋯ NIPSV proved to be equally effective in improving vital signs and ventilation without increasing acute myocardial infarction rate in patients with nonischemic acute pulmonary edema in comparison to CPAP alone. However, because the study lacked statistical power and excluded patients with acute coronary syndromes, caution is still advised when applying NIPSV to the latter subgroup of patients.