Clinical intensive care : international journal of critical & coronary care medicine
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Clin Intensive Care · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialHaemodynamic effects of pressure-controlled ventilation versus volume-controlled ventilation in patients submitted to cardiac surgery.
To compare the haemodynamic effects of pressure-controlled ventilation (PCV) with volume-controlled ventilation (VCV) in patients after cardiac surgery. ⋯ PC and VC ventilatory modes had comparable effects on patients with preserved or depressed cardiac output. Patients ventilated with PCV showed significantly higher values for cardiac index, a decreased SVR, as well as significantly lower values for inspiratory pressure when compared with VCV patients.
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Clin Intensive Care · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialCost of ICU sedation: comparison of empirical and controlled sedation methods.
A randomised crossover study was undertaken to compare the quality and cost of controlled versus empirical sedation with midazolam in critically ill patients. Patients (n = 40) entering the ICU were enrolled provided they satisfied the strict entry criteria. During 90 hours of midazolam sedation, patients received randomly allocated 10-hour periods of controlled or empirical sedation. ⋯ In a separate study on 352 patients, a cost-benefit analysis of controlled sedation with midazolam or propofol infusion or bolus injections of morphine plus diazepam showed that the quality of sedation achieved with propofol was superior to the other two regimens and that, with morphine plus diazepam, the quality of sedation was unacceptably poor. Although the direct purchase price of propofol was higher than that of other agents, the total cost of sedation with propofol was lower than that for midazolam for short-term intensive care (less than 24 hours) and comparable to midazolam for longer-term use. However, indirect benefits of sedation with propofol include a much shorter ICU stay with the attendant reduced nursing costs and greater throughout the patients, and this more than compensates for the higher purchase price of the agent.