Search results for "Critical"

Ultrasound-guided infraclavicular cannulation of the subclavian vein – still an ongoing misconception

2020

Diagnostische und therapeutische Bedeutung von Base Excess und Laktatkonzentration

2002

Chronic total coronary occlusions and the Occluded Artery Trial. A critical appraisal.

2008

The OAT trial and its angiographic substudy TOSCA-2, along with a number of published commentaries, represents examples of over-interpretation of clinical study results. A study that achieved no statistically significant result for any of the study endpoints can only claim to have proven that their null hypothesis cannot be rejected. The lack of power due to a reduction of patient numbers by one third, and an unexpected low event rate, makes it not unlikely that another trial would be able to disprove the null hypothesis. These statistical facts should be accepted by the authors and commentators. Instead, the inconclusive results were interpreted in such a way that they might apply to patie…

Emergent and delayed hybrid external fixation management of tibial pilon fractures: A multicentric retrospective analysis of 80 patients

2017

Objective: To report our experience with the hybrid external fixator in emergency. Methods: We assessed 80 cases of pilon fracture treated with the external fixator during the period of January 2009 and December 2016:55 men (69%) and 30 women (33%) with a mean age of 40 years (range between 16 and 70). About 45 occurred as isolated trauma, 35 instead were politrauma. Each patient underwent standard radiographic examination and a CT examination. There were 28 open fractures (35%), (Gustilo type 1, 2 and 3) while closed fractures showed soft tissue involvement of various grade (2-3 Tscherne classification). In all cases, the external fixation, sometimes associated with other reduction and syn…

Evaluation of automated hematologic VCS parameters in severe sepsis and septic shock: a case-control study.

2010

A cheap and quick hematologic diagnostic parameter for detection of sepsis would have both economic and therapeutic benefits. The Coulter LH series hematology analyzer uses the VCS technology (Volume, Conductivity, Laser Scatter) providing information about cell volume, size, internal structure, and surface morphology. Many authors analyzed the clinical usefulness of VCS parameters in reactive neutrophils for detection of sepsis. An increase in mean cell volume and a decrease in mean light scatter in septic patients have been described. Our aim is to verify the correlation between VCS parameters and sepsis.

Novel hybrid technology for early diagnostics of sepsis

2017

Sepsis is a potentially fatal disease with mortality rate as high as 50% in patients with septic shock; mortality rate can increase by 7.6% per hour if appropriate treatment is not started. Internationally accepted guidelines for diagnosis of sepsis rely on vital sign monitoring and laboratory tests in order to recognize organ failure. This pilot study aims to explore the potential of hyperspectral and thermal imaging techniques to identify and quantify early alterations in skin oxygenation and perfusion induced by sepsis. The study comprises both physiological model experiments on healthy volunteers in a laboratory environment, as well as screening case series of patients with septic shock…

Pathophysiology of Hypovolemic Shock

2001

Determinants of helicopter benefit for the transport of severe trauma patients

2013

Recently, Galvagno commented on the paper of Andruszkow and colleagues and summarized the studies using multivariate logistic regression to compare helicopter transport (HT) versus ground transport of trauma patients [1,2]. The authors did not mention our analysis of 1,958 trauma patients (26% transported by HT) specifically performed to investigate the influence of the mode of transport from the database of the French Intensive care Recorded in Severe Trauma study [3,4]. Compared with ground transport, HT patients were more intensively treated in the prehospital phase. The need for emergency surgical procedures and overall head surgical procedures until discharge from hospital were higher …

Effects of Tolazoline and Prostacyclin on Pulmonary Hypertension in Infants After Cardiac Surgery

1992

Objective To evaluate the hemodynamic effects of tolazoline and prostacyclin in infants with pulmonary vasospasm after cardiac surgery. Design Prospective cohort study. Setting Pediatric ICU. Patients The cohort consisted of 42 infants and children with congenital heart disease and pulmonary hypertension who underwent corrective surgery and were monitored postoperatively using pulmonary artery catheters. Fourteen infants (2 to 12 months old) in this group required postoperative treatment with tolazoline or prostacyclin. Interventions Tolazoline was administered as a bolus of 0.5 mg/kg for treatment of persistent pulmonary hypertension or acute pulmonary hypertensive crisis. If its effective…

Analgosedierung bei neurochirurgischen Intensivpatienten

1990

Different concepts for analgosedation of neurosurgical patients are recommended during postoperative ventilation. In 30 neurosurgical patients (2 groups of 15 patients), we studied a continuous i.v. application of alfentanil (Rapifen) and midazolam (Dormicum) compared to an application of continuously given alfentanil with discontinuously given midazolam. A good analgosedation (i.e. sufficient sedation with good neurological judgement) was more frequently achieved (8/15 patients) by continuous application of both substances (alfentanil 0.023 mg/kg b.w./h, midazolam 0.10 mg/kg b.w./h), compared to discontinuous application of midazolam (4.5/15 patients; alfentanil 0.028 mg/kg b.w./h, midazol…