Articles: critical-care.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Neuromuscular monitoring by intensive care nurses: comparison of acceleromyography and tactile assessment.
We have compared tactile assessment of the train-of-four (TOF) count and TOF ratio by nursing staff, with measurements made by a new acceleromyographic monitor, the TOF-Watch. We assessed neuromuscular block in 30 sedated intensive care patients receiving a continuous infusion of atracurium. ⋯ Each assessment was paired with a blinded TOF-Watch measurement. The nurses were accurate in assessing twitch count in 55% of measurements and they tended to overestimate the degree of block using tactile assessment of TOF ratio.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 1998
Randomized Controlled Trial Clinical Trial[Pulse oximetry and capnography in intensive care transportation: combined use reduces transportation risks].
Due to the growing number of diagnostic and therapeutical procedures intensive-care patients must be transported intra- and interhospitally more often. These transports are among the most critical events during intensive-care therapy, with a high incidence of potentially life-threatening mishaps [23]. The aim of this study was to evaluate the possible benefit of the combined application of pulse oximetry and capnometry for patient safety during transport. ⋯ The combination of pulse oximetry and capnometry offers the possibility to detect potentially life-threatening problems in ventilated patients during transport. This allows for early therapeutical consequences and may help to reduce the risk of transports.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1998
Randomized Controlled Trial Clinical Trial[Cause-oriented prevention of nosocomial pneumonia: the HI-LO EVAC tube].
Surgical high-risk patients were studied in a prospective randomized trial regarding nosocomial pneumonia (NP) using a subglottic lavage (SL). A total of 100 patients were investigated, in whom the primary infection was localized in the oropharynx. Independent of the kind of stress ulcer prophylaxis, intermittent subglottic lavage reduces the incidence of NP drastically to 3%, which is however, without statistical significance.
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Journal of critical care · Dec 1997
Randomized Controlled Trial Clinical TrialFewer interventions in the immediate post-extubation management of pediatric intensive care unit patients: safety and cost containment.
The purpose of this article was to compare the safety and patient charges of two postextubation treatment regimens. ⋯ A modified postextubation management protocol, consisting of fewer interventions, resulted in significant patient charge savings with no increased risk to the patient.
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Critical care medicine · Dec 1997
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialProtocol-guided diuretic management: comparison of furosemide by continuous infusion and intermittent bolus.
To evaluate the safety and relative effectiveness of two diuretic protocols in the intensive care unit (ICU). ⋯ Protocol-guided diuretic management, with individualized titration of dosage to defined physiologic endpoints can be readily and safely implemented in the ICU. Both continuous and bolus diuretic regimens appear equally effective in achieving negative fluid balance. Larger studies with a randomized control arm are needed before these protocols can be recommended as routine practice.