Critical care medicine
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Critical care medicine · Mar 2005
Multicenter Study Clinical TrialCombining high-frequency oscillatory ventilation and recruitment maneuvers in adults with early acute respiratory distress syndrome: the Treatment with Oscillation and an Open Lung Strategy (TOOLS) Trial pilot study.
To determine the safety, feasibility, and lung-recruitment efficacy of an explicit ventilation protocol combining high-frequency oscillatory ventilation and recruitment maneuvers. ⋯ The combination of high-frequency oscillatory ventilation and recruitment maneuvers resulted in rapid and sustained improvement in oxygenation, likely through lung recruitment. This explicit high-frequency oscillatory ventilation protocol appears well tolerated, feasible, and physiologically sound.
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Critical care medicine · Mar 2005
Comparative Study Clinical TrialComparison of two bispectral index algorithms in monitoring sedation in postoperative intensive care patients.
Comparison of two versions of bispectral index (BIS) derived from the electroencephalogram in mechanically ventilated and continuously sedated patients after major abdominal surgery. ⋯ The newer algorithm BIS XP did not perform better than the previous version BIS in patients after major surgery who were mechanically ventilated and sedated on an intensive care unit. This precludes the use of BIS or BIS XP for distinguishing, among deeply sedated ICU patients, those with and without preserved cerebral electrical activity.
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Critical care medicine · Mar 2005
ReviewHigh-frequency oscillatory ventilation in adults: respiratory therapy issues.
To summarize clinical information and assessment techniques relevant to respiratory therapists caring for adult patients on high-frequency oscillatory ventilation (HFOV). ⋯ Respiratory therapy assessment and procedural skills are essential in providing optimal care to adult patients on HFOV.
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Critical care medicine · Mar 2005
Randomized Controlled Trial Clinical TrialEffect of hypertonic saline dextran on acid-base balance in patients undergoing surgery of abdominal aortic aneurysm.
To evaluate the magnitude and cause of metabolic acidosis after infusion of 7.5% sodium chloride 6% dextran 70. ⋯ Both the intravenous administration of 7.5% sodium chloride and the conventional fluid regimen with saline-based 6% hydroxyethyl starch solution resulted in a metabolic acidosis of equal extent. This suggests dilution of plasma buffers or a decrease in strong ion difference to be the primary cause of metabolic acidosis.
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Critical care medicine · Mar 2005
ReviewHigh-frequency oscillatory ventilation: mechanisms of gas exchange and lung mechanics.
Overview of the mechanisms governing gas transport, mechanical factors influencing the transmission of pressure and flow to the lung, and the measurement of lung mechanics during high-frequency oscillatory ventilation (HFOV) in acute respiratory distress syndrome. ⋯ Awareness of the different mechanisms governing gas transport and the prevailing lung mechanics during HFOV represents essential background for the physician planning to use this mode of ventilation in the adult patient. Monitoring of lung volume, respiratory mechanics, and ventilation homogeneity may facilitate individual optimization of HFOV ventilatory settings in the future.