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  • 1
    Electronic Resource
    Electronic Resource
    Severe head injuries: An outcome prediction and survival analysis (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1391-1395 
    Details
    ISSN: 1432-1238
    Keywords: Head injury ; Prognosis ; Trauma severity ; Grading system ; Logistic regression model ; Cox regression analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To identify the predictors determined early after admission and associated with unfavorable outcome or early (within 48 h) death after severe head injury. Design Prospective cohort study. Setting A neurosurgical intensive care unit in a university hospital. Patients 198 consecutive comatose patients hospitalized from 1989 to 1992. Results Logistic regression showed that a combination of age, best motor response score from the Glasgow Coma Scale, and hypoxia provided a good prediction model of unfavorable outcome (sensitivity=0.93). The length of participation of survivors was 6 to 61 months (median 27.1). The Cox model demonstrated age, motor score less than 3, mydriasis, and hypoxia as poor prognosis factors. Conclusions Clinicians can determine the odds of a good outcome from the combination of three easily measurable factors using a simple diagram constructed from logistic regression. Survival analysis showed that motor score adjusted values greater than 3 had the same prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709556
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Severe head injuries: an outcome prediction and survival analysis (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1391-1395 
    Details
    ISSN: 1432-1238
    Keywords: Key words Head injury ; Prognosis ; Trauma severity ; Grading system ; Logistic regression model ; Cox regression analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To identify the predictors determined early after admission and associated with unfavorable outcome or early (within 48 h) death after severe head injury. Design: Prospective cohort study. Setting: A neurosurgical intensive care unit in a university hospital. Patients: 198 consecutive comatose patients hospitalized from 1989 to 1992. Results: Logistic regression showed that a combination of age, best motor response score from the Glasgow Coma Scale, and hypoxia provided a good prediction model of unfavorable outcome (sensitivity=0.93). The length of participation of survivors was 6 to 61 months (median 27.1). The Cox model demonstrated age, motor score less than 3, mydriasis, and hypoxia as poor prognosis factors. Conclusions: Clinicians can determine the odds of a good outcome from the combination of three easily measurable factors using a simple diagram constructed from logistic regression. Survival analysis showed that motor score adjusted values greater than 3 had the same prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709556
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Combined Effects of Hypocapnia and Nicardipine on Airway Resistance: a pilot study (1997)
    Springer
    European journal of clinical pharmacology 51 (1997), S. 385-388 
    Details
    ISSN: 1432-1041
    Keywords: Key words Pulmonary resistance ; Hypocapnia ; Nicar-dipine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: The aim of this study was to investigate the modification of the resistive inspiratory properties of the respiratory system associated with hypocapnia in the presence of nicardipine. Methods: The resistance of the respiratory system, Rrsmin, was studied in two groups of patients who needed mechanical hyperventilation. Group 1 (n = 14; 47 years) was the control group (head injuries); group 2 (n␣=␣12; 53.5 years) included patients treated over a 3 week period with nicardipine (0.5 μg · kg−1 · min−1 i.v. ) to prevent arterial vasospasm after subarachnoid haemorrhage. Results: There was no statistical difference between the groups concerning anthropometric and basal respiratory characteristics. In group 1, hypocapnia caused a 20.9% increase in Rrsmin, but no significant increase was observed in group 2. Conclusion: Hypocapnic alkalosis had a significant bronchial constrictory effect, which was eliminated in the presence of nicardipine hydrochloride.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002280050218
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Systemic vasomotor interaction between nicardipine and hypocapnic alkalosis in man (1992)
    Springer
    Intensive care medicine 18 (1992), S. 89-92 
    Details
    ISSN: 1432-1238
    Keywords: Vasomotricity ; Hypocapnic alkalosis ; Nicardipine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of hypocapnic alkalosis on the vasodilating action of nicardipine were studied in 6 patients after cerebral arterial aneurysm surgery. Each patient served as his/her own control during the 6 steps of the study. T0: baseline; T1: hypocapnic alkalosis alone (PaCO2: 3.5 kPa); T2: hypocapnic alkalosis and bolus injection of nicardipine (30 μg·kg−1 i.v.); T3: hypocapnic alkalosis and continuous 60 min infusion of nicardipine (0.5 μg·kg−1·min−1), T4: determination of the infusion rate required to neutralize the effect of hypocapnic alkalosis; T5: same continuous dose of nicardipine as in T4 but reversal of hypocapnic alkalosis. Hypocapnic alkalosis alone caused a significant increase in the systemic vascular resistance index by 20% (T1). The bolus injection of nicardipine reversed this first effect (T2). The continuous infusion of nicardipine in T3 was insufficient to cancel the haemodynamic effect of hypocapnic alkalosis. During T4 the plasma levels required to neutralize completely the effect of hypocapnic alkalosis were twice those at T3. Normalization of the PaCO2 in step T5 induced a significant fall in the systemic vascular resistance index by 27.5% as compared with T0. In this study hypocapnic alkalosis modified the relationship between plasma levels of nicardipine and its expected vasoactive effects. This interaction was reversible.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01705038
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    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Nosocomial pneumonia in mechanically ventilated patients, a prospective randomised evaluation of the Stericath closed suctioning system (2000)
    Springer
    Intensive care medicine 26 (2000), S. 878-882 
    Details
    ISSN: 1432-1238
    Keywords: Key words Nosocomial pneumopathy ; Mechanical ventilation ; Cox model ; Closed suctioning device ; ICU
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To compare the ventilator-associated pneumonia (VAP) incidence rates in mechanically ventilated patients according to the type of endotracheal suctioning (closed versus open). Setting: The Neurosurgery Intensive Care Unit of the Grenoble University Hospital, France. Design: A prospective randomised study performed after a 6-month period of nursing personnel training. Patients: One hundred four consecutive patients needing mechanical ventilation for more than 48 h were randomised into two groups. To be eligible, patients had to have no active infection or respiratory affection in their passes. In the Stericath group (S + , n = 54), patients were not disconnected from the ventilator during suctioning. The others were routinely managed (S–, n = 50). In both groups patterns of frequency and duration of suctioning were performed according to a standardised protocol.¶Measurements: The non-adjusted incidence rate of VAP was lower for S + than for S– (7.32 versus15.89 per 1000 patient-days, p = 0.07). Multivariate analysis performed using the Cox model showed an adjusted risk of VAP 3.5 times higher in S– (95 %Cl: 11.00–12.33). The risk being 4.3 higher in patients receiving gastric acid secretion inhibitors (1.08–16.82). In non-censored cases (n = 76) length of ICU stay increased by an average of 16.8 days when VAP was present (p = 0.0008). No adverse effect due to Stericath use was noted and volume of tracheal aspirate was similar between groups (p = 0.178). Conclusion: The use of Stericath reduced the incidence rate of VAP without demonstrating any adverse effect.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051276
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    Paper (German National Licenses)
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