Articles: critical-care.
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Critical care medicine · Feb 2000
Randomized Controlled Trial Clinical TrialMedical students can learn the basic application, analytic, evaluative, and psychomotor skills of critical care medicine.
To determine whether fourth-year medical students can learn the basic analytic, evaluative, and psychomotor skills needed to initially manage a critically ill patient. ⋯ Fourth-year medical students without a CCM elective do not possess the basic cognitive and psychomotor skills necessary to initially manage critically ill patients. After an appropriate 1-month CCM elective, students' thinking and application skills required to initially manage critically ill patients improved markedly, as demonstrated by an OSCE using a live simulated "patient" and manikin.
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Critical care medicine · Nov 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialThe effect of acidified enteral feeds on gastric colonization in critically ill patients: results of a multicenter randomized trial. Canadian Critical Care Trials Group.
To evaluate the effect of acidified enteral feeds on gastric colonization in critically ill patients compared with a standard feeding formula. ⋯ Acidified enteral feeds preserve gastric acidity and substantially reduce gastric colonization in critically ill patients. Larger studies are needed to examine its effect on ventilator-associated pneumonia and mortality.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Analgo-sedation in intensive care: a quantitative, EEG-based trial with propofol 1% and 2%].
The primary aim of this study was to find out whether adequate long-term sedation (> or = 72 h) can be achieved in critically ill patients with an EEG median frequency controlled closed-loop system for the application of propofol 1% and 2%. Moreover, we investigated the pharmacokinetics and pharmacodynamics of propofol with respect to possible tolerance and compared the quality of sedation of both propofol formulations and their lipid load. ⋯ The EEG median frequency can be used for closed-loop control of propofol even for long-term sedation in critically ill patients. EEG median frequencies were similarly low as in deeply anaesthetised patients. No differences in quality of sedation were seen between the two propofol formulations, but propofol 2% seems to be advantageous due to lower lipid load and triglyceride values. Increasing concentrations of propofol at unchanged sedation scores and EEG median frequencies may indicate development of tolerance.
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Intensive care medicine · Jul 1999
Randomized Controlled Trial Clinical TrialPatient-ventilator asynchrony during noninvasive ventilation: the role of expiratory trigger.
Air leaks around the mask are very likely to occur during noninvasive ventilation, in particular when prolonged ventilatory treatment is required. It has been suggested that leaks from the mask may impair the expiratory trigger cycling mechanism when inspiratory pressure support ventilation (PSV) is used. The aim of this study was to compare the short-term effect of two different expiratory cycling mechanisms (time-cycled vs flow-cycled) during noninvasive inspiratory pressure support ventilation (NIPSV) on patient-ventilator synchronisation in severe hypoxemic respiratory failure. ⋯ In the presence of air leaks a time-cycled expiratory trigger provides a better patient-machine interaction than a flow-cycled expiratory trigger during NIPSV.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prevention of hypotension after induction of anesthesia after preoperative tune-up. A preliminary report of the Groningen Tune-up Study.
To investigate whether the frequently occurring hypotension after induction of anesthesia can be prevented by preoperative treatment at the ICU guided by hemodynamic data obtained from a pulmonary artery (PA) catheter. ⋯ Hypotension after induction of anesthesia is significantly attenuated by preoperative treatment aiming at a CI > or = 4.0 l/min/m2 in high risk patients planned for major vascular- or abdominal surgery.