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  1. Article: Clinical review: high-frequency oscillatory ventilation in adults--a review of the literature and practical applications.

    Ritacca, Frank V / Stewart, Thomas E

    Critical care (London, England)

    2003  Volume 7, Issue 5, Page(s) 385–390

    Abstract: It has recently been shown that strategies aimed at preventing ventilator-induced lung injury, such as ventilating with low tidal volumes, can reduce mortality in patients with acute respiratory distress syndrome (ARDS). High-frequency oscillatory ... ...

    Abstract It has recently been shown that strategies aimed at preventing ventilator-induced lung injury, such as ventilating with low tidal volumes, can reduce mortality in patients with acute respiratory distress syndrome (ARDS). High-frequency oscillatory ventilation (HFOV) seems ideally suited as a lung-protective strategy for these patients. HFOV provides both active inspiration and expiration at frequencies generally between 3 and 10 Hz in adults. The amount of gas that enters and exits the lung with each oscillation is frequently below the anatomic dead space. Despite this, gas exchange occurs and potential adverse effects of conventional ventilation, such as overdistension and the repetitive opening and closing of collapsed lung units, are arguably mitigated. Although many investigators have studied the merits of HFOV in neonates and in pediatric populations, evidence for its use in adults with ARDS is limited. A recent multicenter, randomized, controlled trial has shown that HFOV, when used early in ARDS, is at least equivalent to conventional ventilation and may have beneficial effects on mortality. The present article reviews the principles and practical aspects of HFOV, and the current evidence for its application in adults with ARDS.
    MeSH term(s) Adult ; High-Frequency Ventilation/methods ; Humans ; Positive-Pressure Respiration/adverse effects ; Respiratory Distress Syndrome, Adult/etiology ; Respiratory Distress Syndrome, Adult/mortality ; Respiratory Distress Syndrome, Adult/prevention & control
    Language English
    Publishing date 2003-10
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2041406-7
    ISSN 1364-8535
    ISSN 1364-8535
    DOI 10.1186/cc2182
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5517: Show issues Location:
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  2. Article: Pro/con clinical debate: are steroids useful in the management of patients with septic shock?

    Ritacca, Frank V / Simone, Carmine / Wax, Randy / Craig, Katherine G / Walley, Keith R

    Critical care (London, England)

    2002  Volume 6, Issue 2, Page(s) 113–116

    Abstract: Decision-making in the intensive care unit is often very difficult. Although we are encouraged to make evidence-based decisions, this may be difficult for a number of reasons. To begin with, evidence may not exist to answer the clinical question. Second, ...

    Abstract Decision-making in the intensive care unit is often very difficult. Although we are encouraged to make evidence-based decisions, this may be difficult for a number of reasons. To begin with, evidence may not exist to answer the clinical question. Second, when there is evidence it may not be applicable to the patient in question or the clinician may be reluctant to apply it to the patient based on a number of secondary issues such as costs, premorbid condition or possible complications. Finally, emotions are often highly charged when caring for patients that have a significant chance of death, and care-givers as well as families are frequently prepared to take chances on a therapy whose benefit is not entirely clear. Steroid use in septic shock is an example of a therapy that makes some sense but has conflicting support in the literature. In this issue of Critical Care Forum, the two sides of this often heated debate are brought to the forefront in an interesting format.
    MeSH term(s) Adrenal Cortex Hormones/administration & dosage ; Adrenal Cortex Hormones/adverse effects ; Adrenal Cortex Hormones/therapeutic use ; Attitude of Health Personnel ; Critical Care/methods ; Dose-Response Relationship, Drug ; Humans ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Shock, Septic/drug therapy
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2002-02-06
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2041406-7
    ISSN 1364-8535
    ISSN 1364-8535
    DOI 10.1186/cc1467
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5517: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

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