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OBJECTIVE To determine the rate of complications following the use of femoral catheters in adults. DESIGN Prospective survey of major and minor complications. SETTING A mixed medical/surgical intensive care unit (ICU) in a university hospital. PATIENTS Eighty consecutive patients admitted to the ICU who underwent right femoral venous catheterization(More)
OBJECTIVE To determine the frequency of central venous catheter-induced thrombosis of the axillary vein. DESIGN Prospective, controlled study. SETTING Tertiary care university center. PATIENTS Sixty patients in a medical-surgical intensive care unit who required central venous catheterization via the axillary vein. INTERVENTIONS Single-lumen,(More)
BACKGROUND AND STUDY AIMS Complications of endoscopic sphincterotomy (ES) have been assessed in recent multicenter studies. The aim of this series was to report and identify risk factors for complications of ES at a single tertiary referral center. PATIENTS AND METHODS Between 1996 and 2000, 1159 consecutive endoscopic retrograde(More)
OBJECTIVES To determine the rate of lower extremity deep vein thrombosis after the use of femoral catheters in intensive care unit (ICU) comatose or sedated adults. Results were then compared with results of patients undergoing superior vena cava catheterization. DESIGN Prospective, randomized, controlled, unblinded study. SETTING A mixed(More)
STUDY OBJECTIVE The aims of the study were to evaluate the technique of selective digestion decontamination (SDD) in preventing the development of nosocomial infections in a selected population and to assess the effects on colonization of the oropharynx, nares, and bronchi. A financial assessment was also performed. DESIGN Prospective, double-blind,(More)
OBJECTIVE Despite increasingly sophisticated critical care, the mortality of septic shock remains elevated. Accordingly, care remains supportive. Volume resuscitation combined with vasopressor support remains the standard of care as adjuvant therapy, and many consider dopamine to be the pressor of choice. Because of fear of excessive vasoconstriction,(More)
OBJECTIVES To determine the effects of bolus injection and infusion of sufentanil, alfentanil, and fentanyl on cerebral hemodynamics and electroencephalogram activity in patients with increased intracranial pressure (ICP) after severe head trauma. DESIGN Randomized, unblended, crossover study. SETTING Intensive care unit and trauma center in a(More)
BACKGROUND Sufentanil is an intravenous opioid often used as a component of anesthesia during neurosurgical procedures. However, the effects of sufentanil on intracranial pressure in patients with diminished intracranial compliance are not well established, and remain controversial. METHODS Ten patients with head trauma, in each of whom the trachea was(More)
OBJECTIVE The manual injection of a bolus of opioid in patients with brain injury induces an increase in intracranial pressure related to a decrease in mean arterial pressure. Such an effect has not been observed with the use of ketamine. The use of target-controlled infusion would minimize or suppress this adverse effect of opioid. This study evaluated the(More)
OBJECTIVE Sepsis and septic shock are a common cause of mortality in critically ill patients. Many substances have been implicated in the pathophysiology of these syndromes. We postulated that adenosine may be implicated in the sepsis- or septic shock-induced blood pressure failure. Indeed, this nucleoside is a strong endogenous vasodilating agent released(More)