Critical care medicine
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Critical care medicine · May 2006
ReviewFresh frozen plasma and platelet transfusion for nonbleeding patients in the intensive care unit: benefit or harm?
Whereas restrictive red cell transfusion has become a standard of care for the critically ill, evidenced-based indications for use of other blood components such as fresh frozen plasma (FFP) and platelet transfusions are limited. We searched the National Library of Medicine PubMed database as well as references of retrieved articles and summarized the current evidence for the use of FFP and platelet transfusions in critically ill patients. ⋯ Because the risk-benefit ratio of a liberal FFP or platelet transfusion strategy for critically ill patients may not be favorable, randomized controlled trials are warranted for evaluating a restrictive vs. liberal FFP or platelet transfusion strategy for nonbleeding patients in the intensive care unit.
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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
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 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.