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Objective: To assess volume replacement strategies on intensive care units (ICUs) in Germany. Design: A postal survey questionnaire of 18 questions was sent to 451 ICUs in Germany. The questionnaire was sent to general, surgical, anesthesiology, neurosurgery, cardiac surgery, and medical ICUs of hospitals with more than 200 beds. Results: 286 questionnaires(More)
OBJECTIVE Evaluation of continuous cardiac output monitoring based on the thermodilution technique in the critically ill. DESIGN Prospective clinical investigation. SETTING A surgical intensive care unit of a university hospital. PATIENTS Thirty-five critically ill patients (trauma and/or sepsis patients), who needed pulmonary artery catheterization.(More)
Objective: There are still several concerns about the extensive and prolonged use of hydroxyethylstarch solution (HES) in critically ill patients. The effects of volume replacement with HES over 5 days on hemodynamics, laboratory data, and organ function were compared with volume therapy using human albumin (HA). Design: Prospective, randomized study.(More)
OBJECTIVE To study the influence of long-term volume therapy with different solutions and continuous administration of pentoxifylline on plasma concentrations of circulating adhesion molecules. DESIGN Prospective, randomized study. SETTING A surgical intensive care unit (ICU) of a university hospital. PATIENTS Forty-two patients with sepsis secondary(More)
There is continuing concern on the influence of hydroxethyl starch (HES) on renal function. Prospective, randomized study. University-affiliated medical center. Forty consecutive patients aged >70 years undergoing cardiac surgery using cardiopulmonary bypass. Either low-molecular HES (mean molecular weight: 130 kD) with low degree of substitution (0.4) (6%(More)
Since 1982, more than 20 patients with return of spontaneous circulation after cessation of cardiopulmonary resuscitation (Lazarus phenomenon) have been published. We report on another case here. Such cases are probably underreported due to medicolegal concerns. After cessation of resuscitation, each patient should be further monitored for at least 10 min(More)
Various vasoactive substances are involved in the regulation of the macro- and microcirculation. We have investigated if these regulators change during long-term volume therapy with human albumin (HA) or hydroxyethylstarch solution (HES) in trauma and sepsis patients. To maintain pulmonary capillary wedge pressure (PCWP) at 10-15 mm Hg, either 20% HA(More)
INTRODUCTION Several studies have shown that goal-directed hemodynamic and fluid optimization may result in improved outcome. However, the methods used were either invasive or had other limitations. The aim of this study was to perform intraoperative goal-directed therapy with a minimally invasive, easy to use device (FloTrac/Vigileo), and to evaluate(More)
Sufficient intravascular fluid therapy is of major importance in the treatment of the critically ill patient. The present study assessed whether the cardiorespiratory response of long-term volume replacement with low-molecular weight (LMW) hydroxyethyl starch solution (HES) differs from that of human albumin (HA). According to a randomized sequence, 30(More)
We have studied the effects of two types of volume replacement on the microcirculation in an open, controlled study in 45 patients undergoing aorto-coronary bypass grafting whose pulmonary capillary wedge pressure (PCWP) was less than 5 mm Hg. Hypertonic saline prepared in hydroxyethylstarch solution (HS-HES, n = 15) and 6% HES 200/0.5 solution (6% HES; n =(More)