Articles: intensive-care-units.
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Intensive care medicine · Apr 2009
Randomized Controlled Trial Multicenter StudyIron lung versus mask ventilation in acute exacerbation of COPD: a randomised crossover study.
To compare iron lung (ILV) versus mask ventilation (NPPV) in the treatment of COPD patients with acute on chronic respiratory failure (ACRF). ⋯ The sequential use of NPPV and ILV avoided EI in a large percentage of COPD patients with ACRF; ILV was more effective than NPPV on the basis of minor criteria for EI but after the crossover the need of EI on the basis of major criteria and mortality was similar in both groups of patients.
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Pediatric emergency care · Mar 2009
Randomized Controlled Trial Comparative StudyRandomized controlled trial of ultrasound-guided peripheral intravenous catheter placement versus traditional techniques in difficult-access pediatric patients.
We hypothesized that the use of ultrasound guidance would improve the success rate of peripheral intravenous catheter placement in pediatric patients with difficult access in a pediatric emergency department (ED). Our secondary hypotheses were that ultrasound guidance would reduce the number of attempts, the number of needle redirections, and the overall time to catheter placement. ⋯ In a sample of pediatric ED patients with difficult access, ultrasound-guided intravenous cannulation required less overall time, fewer attempts, and fewer needle redirections than traditional approaches.
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Randomized Controlled Trial
Intensive insulin therapy for patients in paediatric intensive care: a prospective, randomised controlled study.
Critically ill infants and children often develop hyperglycaemia, which is associated with adverse outcome; however, whether lowering blood glucose concentrations to age-adjusted normal fasting values improves outcome is unknown. We investigated the effect of targeting age-adjusted normoglycaemia with insulin infusion in critically ill infants and children on outcome. ⋯ Research Foundation (Belgium); Research Fund of the University of Leuven (Belgium) and the EU Information Society Technologies Integrated project "CLINICIP"; and Institute for Science and Technology (Belgium).
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Critical care medicine · Jan 2009
Randomized Controlled TrialThe relationship between early emergency team calls and serious adverse events.
To examine the relationship between early emergency team calls and the incidence of serious adverse events--cardiac arrests, deaths, and unplanned admissions to an intensive care unit--in a cluster randomized controlled trial of medical emergency team implementation (the MERIT study). ⋯ As the proportion of early emergency team calls increases, the rate of cardiac arrests and unexpected deaths decreases. This inverse relationship provides support for the notion that early review of acutely ill ward patients by an emergency team is desirable.
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Intensive care medicine · Jan 2009
Randomized Controlled TrialIntensive care unit-acquired neuromyopathy and corticosteroids in survivors of persistent ARDS.
To determine the incidence and outcomes of intensive care unit-acquired neuromyopathy and to investigate the role of methylprednisolone in survivors of persistent acute lung injury. ⋯ ICU-acquired-neuromyopathy is common among survivors of persistent ARDS and is associated with poorer clinical outcomes. We did not find a significant association between methylprednisolone treatment and neuromyopathy. Limitations of this study preclude definitive conclusions about the causal relationship between corticosteroids and ICU-acquired neuromuscular dysfunction.