Critical care medicine
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Critical care medicine · May 2006
ReviewAlternatives to blood product transfusion in the critically ill: erythropoietin.
To present information regarding the use of recombinant human erythropoietin (rHuEPO) to treat anemia in intensive care unit (ICU) patients ⋯ rHuEPO can be used to increase hemoglobin and hematocrit values and decrease the number of RBC transfusions in ICU patients. Further investigation is necessary to identify the appropriate target population of ICU patients for treatment, to clarify the appropriate dosing schedule, and to ascertain whether such therapy has a positive impact on outcomes.
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Critical care medicine · May 2006
Randomized Controlled Trial Multicenter Study Comparative StudyA randomized trial of intermittent lorazepam versus propofol with daily interruption in mechanically ventilated patients.
To compare duration of mechanical ventilation for patients randomized to receive lorazepam by intermittent bolus administration vs. continuous infusions of propofol using protocols that include scheduled daily interruption of sedation. ⋯ For medical patients requiring >48 hrs of mechanical ventilation, sedation with propofol results in significantly fewer ventilator days compared with intermittent lorazepam when sedatives are interrupted daily.
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Critical care medicine · May 2006
Randomized Controlled Trial Multicenter StudyIgMA-enriched immunoglobulin in neutropenic patients with sepsis syndrome and septic shock: a randomized, controlled, multiple-center trial.
To evaluate the effect of intravenous IgMA-enriched immunoglobulin (ivIGMA) therapy on mortality in neutropenic patients with hematologic malignancies and sepsis syndrome or septic shock. ⋯ Intravenous ivIGMA had no beneficial effects in neutropenic patients with hematologic malignancies and sepsis syndrome and septic shock.
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Critical care medicine · May 2006
Randomized Controlled Trial Comparative StudyClinical and hemodynamic comparison of 15:2 and 30:2 compression-to-ventilation ratios for cardiopulmonary resuscitation.
To compare cardiopulmonary resuscitation (CPR) with a compression to ventilation (C:V) ratio of 15:2 vs. 30:2, with and without use of an impedance threshold device (ITD). ⋯ These data strongly support the contention that a ratio of 30:2 is superior to 15:2 during manual CPR and that the ITD further enhances circulation with both C:V ratios.
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Critical care medicine · May 2006
Randomized Controlled TrialIntravenous injection of methylprednisolone reduces the incidence of postextubation stridor in intensive care unit patients.
To determine whether treatment with corticosteroids decreases the incidence of postextubation airway obstruction in an adult intensive care unit. ⋯ A reduced cuff leak volume is a reliable indicator to identify patients at high risk to develop stridor. Treatment with a single or multiple injections of methylprednisolone can effectively reduce the occurrence of postextubation stridor.