Search results for "Critical Care and Intensive Care Medicine"

Neurally adjusted ventilatory assist: An update

2014

Summary Neurally adjusted ventilatory assist (NAVA) is a new ventilation mode that provides a proportional assistance to the inspiratory effort of the patients. It is based on the use of the diaphragm electromyographic activity (Edi) for the control of the ventilation assistance. The ability of NAVA to improve the limitations of the conventional assisted ventilator modes has been assessed in clinical studies and discussed in this report, as the latest applications of NAVA in children and non-invasive ventilation, due to the improvement of the patient–ventilator interactions delivered by NAVA. We also review the most recent literature on a new trend to use the Edi as a predictor of weaning s…

Right ventricular function and iron deficiency in acute heart failure

2021

Abstract Aims Iron deficiency (ID) is a frequent finding in patients with chronic and acute heart failure (AHF) along the full spectrum of left ventricular ejection fraction (LVEF). Iron deficiency has been related to ventricular systolic dysfunction, but its role in right ventricular function has not been evaluated. We sought to evaluate whether ID identifies patients with greater right ventricular dysfunction in the setting of AHF. Methods and results We prospectively included 903 patients admitted with AHF. Right systolic function was evaluated by tricuspid annular plane systolic excursion (TAPSE) and the ratio TAPSE/pulmonary artery systolic pressure (TAPSE/PASP). Iron deficiency was de…

Role of biomarkers in the management of antibiotic therapy: an expert panel review II: clinical use of biomarkers for initiation or discontinuation o…

2013

Abstract Biomarker-guided initiation of antibiotic therapy has been studied in four conditions: acute pancreatitis, lower respiratory tract infection (LRTI), meningitis, and sepsis in the ICU. In pancreatitis with suspected infected necrosis, initiating antibiotics best relies on fine-needle aspiration and demonstration of infected material. We suggest that PCT be measured to help predict infection; however, available data are insufficient to decide on initiating antibiotics based on PCT levels. In adult patients suspected of community-acquired LRTI, we suggest withholding antibiotic therapy when the serum PCT level is low (<0.25 ng/mL); in patients having nosocomial LRTI, data are insuf…

Guidelines for the management of women with severe pre-eclampsia

2021

Abstract Objective To provide national guidelines for the management of women with severe pre-eclampsia. Design A consensus committee of 26 experts was formed. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industrial funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. Methods The last SFAR and CNGOF guidelines on t…

2002

Abstracts of scientific papers second international symposium on central nervous system monitoring

1990

Consideraciones y conducta neuroanestesiológica postoperatoria

2012

Surgery of the posterior fossa and/or craniospinal region has a high rate of postoperative morbidity and mortality, which has rarely been described in the scientific literature. This review aims to describe the available evidence in the literature on the complications associated with this type of surgery and its neuroanesthesiological and/ or neurocritical management, as well as to highlight the predisposing factors that can increase the complications rate. Knowledge of the complications related to neurosurgical disorders of the posterior fossa could aid in their prevention or help in the selection of appropriate treatment that would minimize their consequences. A systematic literature sear…

Endexspiratorisches Kohlendioxid und Überleben nach präklinischem Herz-Kreislaufstillstand

1998

Nachruf auf Prof. Dr. med. Sven Effert

2000

The effects of arterial CO2 on the injured brain: Two faces of the same coin

2021

Serum levels of carbon dioxide (CO2) closely regulate cerebral blood flow (CBF) and actively participate in different aspects of brain physiology such as hemodynamics, oxygenation, and metabolism. Fluctuations in the partial pressure of arterial CO2 (PaCO2) modify the aforementioned variables, and at the same time influence physiologic parameters in organs such as the lungs, heart, kidneys, and the gastrointestinal tract. In general, during acute brain injury (ABI), maintaining normal PaCO2 is the target to be achieved. Both hypercapnia and hypocapnia may comprise secondary insults and should be avoided during ABI. The risks of hypocapnia mostly outweigh the potential benefits. Therefore, i…