coma confusion and agitation in intensive care

... have influenced our findings Clifford and Buchman [18] reported that the combination of benzodiazepine and fentanyl affected information processing in response to novel and standard stimuli in ... presented individual data points and used statistical analysis only to show trends in our findings Conclusion In a group of intensive care patients, with heterogeneous diagnosis and reasons for intensive ... responsive and cooperative (SAS score 4) within 30 after discontinuation of propofol Weaning and extubation were successful in 10 patients, whereas sedation was electively restarted in the remaining nine...

Ngày tải lên: 12/08/2014, 20:20

... Passive leg raising Intensive Care Med 2008, 34:659-663 Michard F, Teboul JL: Using heart-lung interactions to assess fluid responsiveness during mechanical ventilation Crit Care 2000, 4:282-289 ... cardiac filling pressures with inherent high risks of pulmonary oedema development, in particular in cases of altered pulmonary vascular permeability In this regard, there is now increasing evidence ... Critical Care Vol 13 No Teboul and Monnet on the flat part of the Frank-Starling curve, as does a failing heart In this condition, further fluid administration should dramatically increase cardiac...

Ngày tải lên: 13/08/2014, 18:22

... manuscript, and participated in discussing the results and revising the article LB participated in designing and coordinating the study, discussing the results, and revising the article ME assisted in ... for use in the intensive care environment [12,13] In this study, we investigated the NEECHAM scale in comparison with the CAM-ICU in a non-intubated intensive care population Materials and methods ... assessment in the ICU were included Patients of all units were included, resulting in a mixed intensive care population in this study A trained nurse researcher included the patients once daily in the...

Ngày tải lên: 13/08/2014, 10:20

... monitoring of quality indicators fits into the daily routines in the hospital setting, 28% agreed that monitoring does not take too much time, and 30% agreed that monitoring of quality indicators ... onitoring of quality indicators fits into the daily routines in the hospital setting (n=140) 10) M onitoring of quality indicators can be done without huge investments (n=140) 11) M onitoring of ... on indicator scores, and intensivists reported administrative support as the most important facilitating factor These findings imply that in order to implement quality indicators successfully in...

Ngày tải lên: 10/08/2014, 10:23

... Anesthesiology and Intensive Care Medicine Klinikum der Friedrich-SchillerUniversität Bachstrasse 18 07743 Jena Germany Boldt J Department of Anesthesiology and Intensive Care Medicine Klinikum der ... tissue ischemic injury in patients presenting in shock and attempts to rescue patients in shock following the development of the ischemic insult Finally, applying protocolized care in the management ... These include endotoxins and polysaccharide binding proteins, cytokines, leukotrienes, clotting factors, C-reactive protein, histamine, uric acid, catecholamines, and procalcetonin, to name but a...

Ngày tải lên: 10/08/2014, 18:21

... mucosa and serosa This decrease was accompanied by an increase in the intestinal PCO2 gap Administering fluids alone or together with SIN-1 increased flow and mucosal µPO2 to baseline levels SIN-1 ... prostacyclin when no further increase in DO2 could be obtained by volume resuscitation and dobutamine infusion Gastric intramucosal pH (pHi) improved after starting prostacyclin, suggesting an increase ... Alic L, Ince C (2001) Initial clinical experience with OPS imaging for observation of the human microcirculation In: Vincent JL (ed) Yearbook of Intensive Care and Emergency Medicine Springer Verlag,...

Ngày tải lên: 10/08/2014, 18:21

... the increased oxygen demand due to the dobutamine, suggesting both an inadequacy of hemodynamics and/ or an inadequacy of mitochondrial function In fact, considering the dobutamine test as an ‘increased ... (1993) Effects of norepinephrine, epinephrine, and dopamine infusions on oxygen consumption in volunteers Crit Care Med 21:1502–1508 54 Uusaro A, Hartikainen J, Parviainen M, Takala J (1995) ... attempt to increase cardiac output by ensuring that an increase in ventricular filling pressure is achieved Dynamic Changes in CVP Recently there has been interest in using the dynamic changes in CVP...

Ngày tải lên: 10/08/2014, 18:21

... during 170 A B J Groeneveld and J Verheij ALI/ARDS, caused by indirect injury, including sepsis, than caused by direct/inhalational injury, in man Indeed, Holm et al observed no EVLW elevation in ... therapeutic studies utilizing the fiberoptic technique, aimed at preventing or ameliorating an increase in EVLW and subsequent morbidity and mortality, thereby confirming and extending the Mitchell et ... volume and cardiac output continuously Integrating such a monitoring tool into the existing and accepted concepts such as pressureand volume-monitoring seems to be a promising way for new, physiology-directed...

Ngày tải lên: 10/08/2014, 18:21

... Messmer K, Fink MP (eds) Update in Intensive Care and Emergency Medicine Vol 33: Tissue Oxygenation in Acute Medicine Springer-Verlag, Berlin, pp 128–137 56 VanderMeer TJ, Wang H, Fink MP (1995) ... PEEP and hepatic metabolic performance in septic shock Intensive Care Med 22:1274–1275 23 De Backer D, Creteur J, Silva E, Vincent JL (2003) Effects of dopamine, norepinephrine and epinephrine ... transient hypovolemia in man Intensive Care Med 20:414–420 50 Schlichtig R, Bowles SA (1994) Distinguishing between aerobic and anaerobic appearance of dissolved CO2 in intestine during low flow J Appl...

Ngày tải lên: 10/08/2014, 18:21

... flow using pulsed Doppler and analyzing tricuspid annulus movement using Doppler tissue imaging (DTI) More interestingly, in spontaneously breathing patients, the collapsibility index, defined ... than cm in normovolemia and may be more than 1.5 cm in hypovolemia In spontaneously breathing patients, the interatrial septum moves during inspiratory and expiratory phases During the inspiratory ... value in predicting an increase in cardiac output in response to fluid infusion in patients with cardiovascular instability [1] In patients with sepsis-induced hypotension, responders and non-responders...

Ngày tải lên: 10/08/2014, 18:21

... approximately h, acquiring simultaneous paired cardiac index data points at 1-min intervals The data points were analysed using SPSS for Windows release 6.1 (SPSS Inc, Chicago, Illinois, USA) and r was calculated ... accuracy and reliability in ICU patients [9,10] Correct placement of the eight electrodes is important in obtaining accurate information; in ICU patients this may be hampered by dressing covering internal ... -0.16 l/min/m2, but with a standard deviation (precision) of ± 1.16 l/min/m2 The lower and upper limits of agreement were -2.48 and 2.16 l/min/m respectively Bland–Altman analysis of individual...

Ngày tải lên: 12/08/2014, 18:20

... dosing algorithm for maintaining adequate sedation and comfort The time elapsed between initiating the SDT and stopping the down-titration (i.e switching back on/increasing the remifentanil infusion ... had finally been discontinued, the patient was switched to standard therapy at the investigator’s discretion Sample acquisition, handling and processing Extensive blood sampling was included in ... patients requiring intensive care Optimal SAS and PI scale scores were well maintained in the group as a whole The provision of analgesia and sedation must be titrated according to individual patient...

Ngày tải lên: 12/08/2014, 20:20

... restrictive multidisciplinary transfusion guidelines and implementing them in daily clinical practice [11], using recombinant human erythropoietin [12] and developing artificial oxygen carriers [13] On ... and meticulously followed physicians’ adherence? Using recombinant human erythropoietin in intensive medicine resulted in clear reductions of allogeneic blood transfusion needs [12] Its use in ... management in intensive care medicine Given the high costs of allogeneic blood transfusions [10], their very selective efficacy [5] and their side effects [7], an improved blood management in intensive...

Ngày tải lên: 12/08/2014, 20:20

... hospitals in six countries in Europe (4 in Greece, in Spain, in Belgium, in The Netherlands, in Germany, in Austria) The study was conducted in accordance with good clinical practice and with ... first Pain was assessed with a six-point Pain Intensity (PI) scale, in which was no pain, was mild pain, was moderate pain, was severe pain, was very severe pain, and was worst possible pain If ... and/ or increases in the infusion rate of propofol up to a maximum dose of mg kg-1 h-1 to attain and then maintain optimum analgesia and sedation The remifentanil infusion rate was increased in...

Ngày tải lên: 12/08/2014, 20:20

... endotracheal intubation are increasingly being recognized, including injury to the larynx and trachea, and patient discomfort In addition, endotracheal intubation often requires the administration of systemic ... with a significant reduction in the Figure intensive care patients by timing of tracheostomy and corresponding Distribution of unit (ICU) length of stay (LOS) intensive care unit (ICU) length of ... of percutaneous and surgical tracheostomies were not different between the early and late groups Tracheostomy timing and main outcomes Table shows tracheostomy timing data and main outcomes Extubation...

Ngày tải lên: 12/08/2014, 20:20

... J: Incidence of recall, nightmare, and hallucination during analgosedation in intensive care Intensive Care Medicine 2002, 28:38-43 Holland C, Cason CL, Prater LR: Patients' recollection in critical ... the Intensive Care Unit Memory tool in the clinical setting Crit Care 2004, 8:R48-R55 17 Wegesin D, Jacobs DM, Zubin NR, Ventura PR, Stern Y: Source memory and encoding strategy in normal aging ... endotracheal suctioning with two methods of suctioning: routine endotracheal suctioning and minimally invasive airway suctioning In the case of routine endotracheal suctioning, a 49 cm suction...

Ngày tải lên: 12/08/2014, 20:20

... Vessey MP: Intensive Care Society's APACHE II study in Britain and Ireland: a prospective, multi-center, cohort study comparing two methods for predicting outcome for adult intensive care patients ... comparisons of intensive care units in Great Britain and Ireland using the APACHE II method In Phd thesis University of Oxford; 1992 Harrison DA, Brady AR, Rowan K: Case mix, outcome and length of ... to adult, general critical care units in England, Wales and Northern Ireland: the Intensive Care National Audit & Research Centre Case Mix Programme Database Crit Care 2004, 8:R99-R111 Grigg...

Ngày tải lên: 12/08/2014, 23:21

... the vessels included in the investigated volume, and inter-individual flow variations [54] In our series, we noted great interindividual variations of blood flows at rest and during reactive ... contraction induced by norepinephrine, acting by an inhibition of Ca2+ influx occurring through voltage-operated Ca2+ channels and through agonistmediated Ca2+ channels and by an inhibition of ... was injected and the injection rate increased by 0.05 μg/kg per hour In case of hypotension or bradycardia, the injection rate was decreased by 0.05 μg/kg per hour and colloid infusion (25 ml/minute)...

Ngày tải lên: 13/08/2014, 03:20

... different cooling methods in inducing and maintaining hypo- and normothermia in ICU patients Cooling using watercirculating blankets, gel-coated water circulating pads and intravascular cooling was ... water-circulating blankets, gel-coated water circulating pads and intravascular cooling are equally efficient in inducing hypothermia and normothermia For maintaining the target temperature, intravascular ... Critical Care Vol 11 No Hoedemaekers et al this study is to compare five different cooling techniques during induction and maintaining of mild hypo- and normothermia in terms of efficiency and cooling...

Ngày tải lên: 13/08/2014, 08:20

... (creatinine + urine output) AKIN criteria (creatinine + urine output) 0.750 RIFLE criteria (creatinine) 0.729 AKIN criteria (creatinine) 0.745 RIFLE criteria (urine output) 0.619 AKIN criteria (urine ... currently defined as an absolute increase in serum creatinine ≥0.3 mg/dl (≥26.4 μmol/l), a percentage increase in serum creatinine ≥50% (1.5-fold from baseline), or a reduction in urine output ... an increase of serum creatinine above the baseline serum creatinine level When the baseline serum creatinine is unknown and there is no past history of chronic kidney disease, serum creatinine...

Ngày tải lên: 13/08/2014, 11:22