Applicability of Vasopressor Trials in Adult Critical Care: A Prospective Multicentre Meta-Epidemiologic Cohort Study.

Objective: To assess the applicability of evidence from landmark randomized controlled trials (RCTs) of vasopressor treatment in critically ill adults.

Study Design And Setting: This prospective, multi-center cohort study was conducted at five medical and surgical intensive care units at three tertiary care centers. Consecutive cases of newly initiated vasopressor treatment were included.

A simple and portable method for on-line texture measurement of Italian "Speck Alto Adige".

Texture is a relevant parameter for the assessment of cured ham's quality. In this study a rapid on-line instrumental technique for the measurement of the texture of pieces of cured smoked ham intended for sale as "Speck Alto Adige" PGI was developed. Speck samples were subjected to a compression test using a portable Shore A tester, and instrumental data were compared with conventional texture analyses (texture profile analysis and stress relaxation test) and with sensory evaluations.

ECMO and cytokine removal for bridging to surgery in a patient with ischemic ventricular septal defect - a case report.

Even in the modern era of percutaneous coronary intervention, postinfarction ventricular septal defect (VSD) remains a serious and often lethal complication. Whether or not immediate surgical repair or delaying surgery a few days aided by intra-aortic counterpulsation provides the optimal strategy remains a matter of debate. An interdisciplinary approach of intensivists and cardiac surgeons in this setting is mandatory.

Vasopressors for hypotensive shock.

Background: Initial goal-directed resuscitation for hypotensive shock usually includes administration of intravenous fluids, followed by initiation of vasopressors. Despite obvious immediate effects of vasopressors on haemodynamics, their effect on patient-relevant outcomes remains controversial. This review was published originally in 2004 and was updated in 2011 and again in 2016.

Inappropriate hospital admission: interaction between patient age and co-morbidity.

The aim of the study is to determine the prevalence of inappropriate admission, and to identify the factors that influence appropriateness of hospital admission. Data were prospectively collected from all 345 consecutive patients admitted during the period of 1 month for acute hospital care at a 110-bed division of internal medicine using socio-demographic and medical information. Statistical analyses included χ2 tests, t tests, and logistic regression analyses.

Vasopressors for hypotensive shock.

Background: Initial goal directed resuscitation for shock usually includes the administration of intravenous fluids, followed by initiating vasopressors. Despite obvious immediate effects of vasopressors on haemodynamics their effect on patient relevant outcomes remains controversial. This review was originally published in 2004 and was updated in 2011.

Accuracy of noninvasive multiwave pulse oximetry compared with carboxyhemoglobin from blood gas analysis in unselected emergency department patients.

Study Objective: Accurate and timely diagnosis of carbon monoxide (CO) poisoning is difficult because of nonspecific symptoms. Multiwave pulse oximetry might facilitate the screening for occult poisoning by noninvasive measurement of carboxyhemoglobin (COHb), but its reliability is still unknown. We assess bias and precision of COHb oximetry compared with the criterion standard blood gas analysis.

Therapeutic hypothermia after cardiac arrest in Lower Austria--a cross-sectional survey.

This study was undertaken to evaluate the use of therapeutic hypothermia (TH) after cardiac arrest in Lower Austria. A questionnaire was sent to intensive care units (ICUs) in Lower Austria. Methods of inducing and maintaining hypothermia, the practise of rewarming, concomitant therapies and reasons not to cool were documented.

Vasopressors for shock.

Background: Besides reversing the underlying cause, the first line treatment for the symptoms of shock is usually the administration of intravenous fluids. If this method is not successful, vasopressors such as dopamine, dobutamine, adrenaline, noradrenaline and vasopressin are recommended. It is unclear if there is a vasopressor of choice, either for the treatment of particular forms of shock or for the treatment of shock in general.

Chest sonography in the diagnosis of pulmonary embolism: a comparison with MRI angiography and ventilation perfusion scintigraphy.

Aim: To compare the diagnostic performance of chest sonography, MRI angiography and ventilation/perfusion intigraphy in pulmonary embolism (PE).

Method: In a prospective clinical study, 55 patients (41 women, 14 men, age 23 - 91 years) with clinical signs of PE were investigated within 48 hours of the onset of symptoms. The final diagnosis was made by MRI angiography (reference method).

Active epistaxis at ED presentation is associated with arterial hypertension.

Epistaxis and hypertension are frequent in the general population, but an association is still controversial. Aim of this retrospective cohort study was to test if active epistaxis at emergency department (ED) presentation is associated with hypertension. Patients with active epistaxis at ED presentation (n = 271; 73%) were compared with controls without active bleeding (n = 101; 27%).

Clinical application of rapid quantitative determination of cardiac troponin-T in an emergency department setting.

Objectives: We analysed the clinical use of Troponin-T compared to creatine kinase MB in a non-trauma emergency department setting.

Background: A newly established single specimen quantitative Troponin T assay allows the clinical application of this parameter. METHODS.

Sepsis-associated purpura fulminans in adults.

Sepsis-associated purpura fulminans is defined as septicemia, shock, disseminated intravascular coagulation and circulatory failure leading to multiple organ dysfunction. 40-70% of patients with sepsis-associated purpura fulminans die. Early prognostic factors in adults have not been well delineated yet.

Use of an age-adjusted Doppler E/A ratio in patients with moderate to severe hypertension.

Objective: To assess the ratio of early (E) to late atrial (A) mitral Doppler peak flow velocity (Doppler E/A ratio) before and after adjustment for age in patients with moderate to severe hypertension, in whom left ventricular diastolic dysfunction is an early finding. Mitral flow patterns can be used to assess diastolic filling characteristics, and the Doppler E/A ratio is the parameter most commonly used, although it is known to be strongly age dependent. There are no established normal values for this ratio.

Hypertension in patients presenting with epistaxis.

Study Objective: We sought to evaluate whether patients with epistaxis in the emergency department have a higher arterial blood pressure compared with patients with other medical emergencies and to study the association of elevated blood pressure during epistaxis with sustained arterial hypertension.

Methods: In a prospective, cross-sectional, prevalence study we compared arterial blood pressure on admission in the ED in 213 consecutive patients treated for epistaxis with that of 213 sex- and age-matched control subjects. In 33 of those patients with elevated blood pressure during epistaxis, we evaluated the prevalence of sustained arterial hypertension.

Measurement of myocardial contractility following successful resuscitation: quantitated left ventricular systolic function utilising non-invasive wall stress analysis.

After successful resuscitation from cardiac arrest, prolonged contractile failure has been demonstrated in animal experiments. No systematic evaluation of myocardial contractility following successful resuscitation after human cardiac arrest exists. The aim of this study was to assess left ventricular contractility following human cardiac arrest with successful resuscitation.

[Thyrotoxic hypokalemic periodic paralysis in a male Kurd].

Thyrotoxic hypokalemic periodic paralysis has been described to occur quite frequently in male Asiatic patients. The syndrome is, however, very rare in patients of Caucasian origin. To our knowledge it has never been described in Austria so far.

Lung sonographic findings in patients with suspected pulmonary embolism.

Purpose: To assess the feasibility and diagnostic performance of lung transthoracic sonography in patients with suspected pulmonary embolism.

Method: In a prospective clinical study we compared sonographic findings of the peripheral lung with various scintigraphic gradings and D-dimer plasma concentrations. One hundred and nineteen consecutive patients with clinical signs of pulmonary embolism were investigated within 24 hours of the onset of symptoms.

Course of blood pressure within the first 12 h of hypertensive urgencies.

Objective: To evaluate the course of blood pressure within 12 h of a hypertensive urgency with or without oral antihypertensive treatment prior to discharge of patients from hospital.

Design: A prospective, double-blinded, placebo-controlled and randomized clinical trial.

Setting: Department of Emergency Medicine in a 2000-bed inner city hospital.

Cardiorespiratory response to free suspension simulating the situation between fall and rescue in a rock climbing accident.

Many factors contribute to the risk of late death after successful rescue in a rock climbing accident. One factor may be hemodynamic and respiratory compromise by free suspension in a rope between fall and rescue. The risk probably results from using a chest harness alone or the combination of a chest harness and a sit harness.