Articles: function.
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To review the function and use of intravenous magnesium in magnesium depleted and non-magnesium depleted patients. ⋯ Magnesium is required in patients who are magnesium depleted and is also of benefit in non-magnesium depleted patients with pre-eclampsia. It may also be of benefit in non-magnesium depleted patients with acute coronary syndromes, arrhythmias, acute asthma, stroke, seizures and spinal cord injury.
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To detail the history, modes, physiological effects, and circuit geometry of non-invasive ventilation. ⋯ Non-invasive ventilation using the modes of CPAP, PSV, BiPAP and NIPPV should be considered in patients with respiratory failure who are unresponsive to conventional therapy, before considering invasive mechanical ventilation.
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To discuss the reasons why 250 ml 7.5% hypertonic saline was chosen as a pre-hospital resuscitation fluid for head injured patients in a multicentred, prospective, randomised controlled trial investigating its long term effects on central nervous system outcome. ⋯ Pre-hospital resuscitation of head injured and hypotensive trauma patients using hypertonic saline, has the potential to reduce long term cerebral injury and reduce social and financial costs to the community.
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To review the requirements and functions of clinical information systems for the critical care environment. ⋯ A high performance CIS is not yet available as an 'off the shelf' product. Close collaboration between the industry and clinicians is important for successful implementation. Clinical awareness of these issues will encourage product development and suitable purchasing strategies.
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To present an overview of the principles of renal replacement therapy, its application in the critically ill patient, and an update of recent research in this area. ⋯ Continuous renal replacement therapy has become commonplace in the management of critically ill patients with acute renal failure. It has the advantage of causing less hypotension and a more gradual return of the fluid and electrolyte status, when compared with intermittent haemodialysis. Recent evidence suggests that it may also be a useful immunomodulator and may be beneficial in the management of patients with multiple organ failure.