Articles: critical-care.
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Randomized Controlled Trial
Continuous low dose diclofenac sodium infusion to control fever in neurosurgical critical care.
Aim of this randomized prospective clinical trial is to compare two methods of antipyretics and evaluate their efficacy in controlling fever during the acute phase of brain damage. ⋯ Low dose DCF infusion is a potential useful strategy for a successful control temperature better than intermittent NSAIDs dosing, minimizing potentially brain-damaging effects of fever.
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Randomized Controlled Trial
Enhanced upper respiratory tract airflow and head fanning reduce brain temperature in brain-injured, mechanically ventilated patients: a randomized, crossover, factorial trial.
Heat loss from the upper airways and through the skull are physiological mechanisms of brain cooling which have not been fully explored clinically. ⋯ Physiologically, this study demonstrates that heat loss through the upper airways and through the skull can reduce parenchymal brain temperature in brain-injured humans and the onset of temperature reduction is rapid. Clinically, in ischaemic stroke, a temperature decrease of 0.27 degrees C may reduce the relative risk of poor outcome by 10-20%. Head fanning may have the potential to achieve a temperature decrease of this order.
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Anaesth Intensive Care · Aug 2006
Randomized Controlled Trial Multicenter StudyHighly conservative phlebotomy in adult intensive care--a prospective randomized controlled trial.
Anaemia in critically ill patients is common and phlebotomy associated blood loss may contribute towards this anaemia. The aims of this study were twofold. Firstly, a survey was conducted to provide a summary of current phlebotomy practices within Australian intensive care units. ⋯ Using our highly conservative protocol, median phlebotomy-associated blood loss was reduced by over 80% (40 ml vs 8 ml P<0.001). Mean haemoglobin fell from 13.7 g/dl to 11.7 g/dl in controls (P=0.002) and from 12.7 g/dl to 11.5 g/dl (P=0.074) in our study group. We conclude that highly conservative phlebotomy is feasible in a critical care unit and is associated with a reduction in blood loss.
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Minerva anestesiologica · Jul 2006
Randomized Controlled TrialThe effects of hydroxyethyl starch solution in critically ill patients.
In the treatment of the critically ill patients an adequate fluid therapy appears to be essential to optimize hemodynamics and to get a suitable tissue perfusion. In this study we have evaluated the effects of volume replacement, carried out with 2 different solutions: hydroxyethyl starch 6% (HAES) and albumin 20% (HA). ⋯ Since hydroxyethyl starch induced a hemodynamic and clinical improvement, these effects translated into an improvement of sensorium and a reduction of APACHE II score, without causing pulmonary edema, we can conclude that hydroxyethyl starch 6% ws 130,000 dalton ms 0.4 (Voluven) is an effective fluid for resuscitation of hypovolemic patients and represent an attractive alternative to albumin.