Articles: critical-care.
-
Critical care medicine · Jun 1996
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative study of propofol versus midazolam in the sedation of critically ill patients: results of a prospective, randomized, multicenter trial.
To compare the effectiveness, characteristics, duration of action, hemodynamic and biochemical effects, and side effects of propofol and midazolam used for continuous intravenous sedation of ventilated critically ill patients. ⋯ In this population of critically ill patients, propofol is an effective and safe alternative for sedation, with some advantages, such as short duration of action and high effectiveness over the conventional regimen with benzodiazepines and opiates.
-
Am. J. Respir. Crit. Care Med. · May 1996
Randomized Controlled Trial Comparative Study Clinical TrialHome versus intensive care pressure support devices. Experimental and clinical comparison.
A bench study using an artificial lung model and a clinical study in patients were performed to evaluate six commercially available home pressure support devices. Six devices were tested in the in vitro study, including five designed for home use and one designed for use in intensive care units. Minimal positive end-expiratory pressure (PEEP) varied across home devices, from 0.5 cm H2O to 4.3 cm H2O. ⋯ However, the esophageal pressure-time product was 30% higher with the home device (165 +/- 93 versus 119 +/- 80 cm H2O/min, p < 0.05). In conclusion, differences exist between devices in terms of occurrence of rebreathing, speed of attainment of stable pressure support level, and expiratory resistance. These differences characterizing the delivery of pressure support may have clinical impact on the inspiratory effort of patients.
-
Critical care medicine · Apr 1996
Randomized Controlled Trial Comparative Study Clinical TrialModulating effects of propofol on metabolic and cardiopulmonary responses to stressful intensive care unit procedures.
Patients in the intensive care unit (ICU) undergo acute increases in metabolic and cardiopulmonary demands in response to routine care interventions, such as chest physical therapy. This study examined whether the short-acting drug, propofol, could blunt the responses to chest physical therapy. ⋯ Propofol, in the doses administered in this study, significantly reduced the hemodynamic and metabolic stresses caused by chest physical therapy.
-
Randomized Controlled Trial Comparative Study Clinical Trial
An economic evaluation of propofol/fentanyl compared with midazolam/fentanyl on recovery in the ICU following cardiac surgery.
A comparison was made of the drug costs and nursing dependency of patients undergoing elective cardiac surgery and routine postoperative recovery for two anaesthetic techniques using either propofol with low dose fentanyl or midazolam with high dose fentanyl. Estimates of resource use were based on a randomised clinical trial undertaken at the Northern General Hospital, Sheffield. Times from entry to the intensive care unit until extubation and discharge were recorded for 70 patients and were transformed to nursing shifts. ⋯ Costs of nursing and drugs were calculated. The total cost of patients in the propofol group was 13.3% less than midazolam patients (p = 0.043, for geometric means Cl 0.4% to 27.8%). The clinical study was not designed for economic endpoints; however, it demonstrated achievable savings in propofol-treated patients.
-
Critical care medicine · Mar 1996
Review Randomized Controlled Trial Clinical TrialTherapy of alcohol withdrawal syndrome in intensive care unit patients following trauma: results of a prospective, randomized trial.
To assess the effect of three different alcohol withdrawal therapy regimens in traumatized chronic alcoholic patients with respect to the duration of mechanical ventilation and the frequency of pneumonia and cardiac disorders during their intensive care unit (ICU) stay. ⋯ There was some advantage in the flunitrazepam/clonidine regimen with respect to pneumonia and the necessity for mechanical ventilation. However, four (7%) patients had to be excluded from the study due to ongoing hallucinations during therapy. Also, cardiac complications were increased in this group. Thus, flunitrazepam/haloperidol should be preferred in patients with cardiac or pulmonary risk. Further studies are required to determine which therapy should be considered.