Search results for "Emergency & Critical Care Medicine"
showing 10 items of 309 documents
Personality of Fragility Fractures of the Pelvis
2017
The personality of pelvic fractures in the elderly differs in many ways from pelvic ring lesions in adults. Only high-energy trauma leads to pelvic ring disruptions. Concomitant lesions of the soft tissues occur frequently. In the elderly, low-energy falls are the rule. The most important symptom is pain, which restricts mobility. Hemodynamic instability in fragility fractures of the pelvis is rare. Emergency stabilization with pelvic binders or sheets, C-clamping or emergency external fixation are not needed. Arteriography and selective embolization is only recommended in the rare patients, who develop an active arterial bleeding due to the pelvic fracture. Especially patients, who are tre…
Electromagnetic distal targeting system does not reduce the overall operative time of the intramedullary nailing for humeral shaft fractures
2018
Abstract Introduction We aimed to evaluate the efficacy of the use of the electromagnetic distal targeting system in treating humeral shaft fracture. Methods Patients were divided in: Group 1) patients that received a distal locking screw placement following the free-hand technique; Group 2) patients in which the distal locking screw was performed using the SURESHOT device. Results No differences were noted comparing Group 1 (freehand) [71,9 range 40–135 min] to Group 2 (SURESHOT)[70, range 25–125 min]. Conclusion The use of the EM distal targeting system doesn't reduce the overall operative time of the humeral shaft fracture fixation using IMN.
Random allogeneic blood transfusion in pigs: characterisation of a novel experimental model.
2019
BackgroundOrgan cross-talk describes interactions between a primary affected organ and a secondarily injured remote organ, particularly in lung-brain interactions. A common theory is the systemic distribution of inflammatory mediators that are released by the affected organ and transferred through the bloodstream. The present study characterises the baseline immunogenic effects of a novel experimental model of random allogeneic blood transfusion in pigs designed to analyse the role of the bloodstream in organ cross-talk.MethodsAfter approval of the State and Institutional Animal Care Committee, 20 anesthetized pig were randomized in a donor and an acceptor (eachn = 8): the acceptor animals …
Mechanical ventilation parameters in critically ill COVID-19 patients: a scoping review
2021
Abstract Background The mortality of critically ill patients with COVID-19 is high, particularly among those receiving mechanical ventilation (MV). Despite the high number of patients treated worldwide, data on respiratory mechanics are currently scarce and the optimal setting of MV remains to be defined. This scoping review aims to provide an overview of available data about respiratory mechanics, gas exchange and MV settings in patients admitted to intensive care units (ICUs) for COVID-19-associated acute respiratory failure, and to identify knowledge gaps. Main text PubMed, EMBASE, and MEDLINE databases were searched from inception to October 30, 2020 for studies providing at least one v…
Experimental lung injury induces cerebral cytokine mRNA production in pigs
2020
Background Acute respiratory distress syndrome (ARDS) is an important disease with a high incidence among patients admitted to intensive care units. Over the last decades, the survival of critically ill patients has improved; however, cognitive deficits are among the long-term sequelae. We hypothesize that acute lung injury leads to upregulation of cerebral cytokine synthesis. Methods After approval of the institutional and animal care committee, 20 male pigs were randomized to one of three groups: (1) Lung injury by oleic acid injection (OAI), (2) ventilation only (CTR) or (3) untreated. We compared neuronal numbers, proportion of neurons with markers for apoptosis, activation state of Ib…
Hypotensive Hemostasis in Patients Presenting with Ruptured Aortic Aneurysm
2017
Hypotensive hemostasis in aortic rupture has been showed to be feasible and advantageous, especially in trauma patients. To date, there are no randomized studies on hypotensive hemostasis in patients with ruptured abdominal aortic aneurysm (rAAA), but observational studies indicate similar advantages when hypotensive hemostasis is used for endovascular aneurysm repair (EVAR) as in trauma patients. Actually, in EVAR for rAAA, a target systolic blood pressure of 90 mmHg or even lower is considered safe in conscious patients. Fluids should be administrated judiciously with the sole aim of maintaining adequate cardiac output and tissue oxygenation, whereas vasoactive pressors or dilatators may …
Clinical practices to promote sleep in the ICU: A multinational survey
2018
PURPOSE: To describe sleep assessment and strategies to promote sleep in adult ICUs in ten countries.METHODS: Multicenter, self-administered survey sent to nurse managers.RESULTS: Response rate was 66% with 522 ICUs providing data. 'Lying quietly with closed eyes' was the characteristic most frequently perceived as indicative of sleep by >60% of responding ICUs in all countries except Italy. Few ICUs (9%) had a protocol for sleep management or used sleep questionnaires (1%). Compared to ICUs in Northern Europe, those in central Europe were more likely to have a sleep promoting protocol (p < 0.001), and to want to implement a protocol (p < 0.001). In >80% of responding ICUs, the …
Humidity of Anaesthetic Gases with Respect to Low Flow Anaesthesia
1994
It has been demonstrated in an experimental study in swine using the scanning electron microscope that a rebreathing technique utilising minimal fresh gas flowrates significantly improves climatization of anaesthetic gases. Consequently, effects of various anaesthetic techniques on airway climate must be assessed, which covers the need for suitable measuring devices. Basic principles and methods of humidity measurement in flowing anaesthetic gases include gravimetric hygrometry, dew point hygrometry, wet-dry bulb psychrometry, mass spectrometry, spectroscopic hygrometry and electrical hygrometry. A custom-made apparatus for continuous measurement of humidity and temperature in the inspired…
Vasopressor and inotrope treatment for septic shock: An umbrella review of reviews
2021
Abstract Purpose To review the characteristics, findings and quality of systematic reviews (SRs) on the effect of any vasopressor/inotrope on outcomes in adult patients with sepsis compared with either no treatment, another vasopressor or inotrope or fluids. Materials and methods We systematically searched Cochrane Central Register of Controlled Trials, PubMed and Embase (January 1993–March 2021). Descriptive statistics were used. Results Among the 28 SRs identified, mortality was the primary outcome in most (26/28) and mortality was usually (23/28) studied using randomised controlled trials (RCTs). Fifteen SRs focused exclusively on patients with sepsis or septic shock. Sepsis and septic s…
B-Lines for the assessment of extravascular lung water: Just focused or semi-quantitative?
2020
BACKGROUND B-lines as typical artefacts of lung ultrasound are considered as surrogate measurement for extravascular lung water. However, B-lines develop in the sub-pleural space and do not allow assessment of the whole lung. Here, we present data from the first observational multi-centre study focusing on the correlation between a B-lines score and extravascular lung water in critically ill patients suffering from a variety of diseases. PATIENTS AND METHODS In 184 adult patients, 443 measurements were obtained. B-lines were counted and expressed in a score which was compared to extravascular lung water, measured by single-indicator transpulmonary thermodilution. Appropriate correlation coe…