Randomized, multicenter trial of lateral Trendelenburg versus semirecumbent body position for the prevention of ventilator-associated pneumonia.

Purpose: The lateral Trendelenburg position (LTP) may hinder the primary pathophysiologic mechanism of ventilator-associated pneumonia (VAP). We investigated whether placing patients in the LTP would reduce the incidence of VAP in comparison with the semirecumbent position (SRP).

Methods: This was a randomized, multicenter, controlled study in invasively ventilated critically ill patients.

Intracranial pressure monitoring after primary decompressive craniectomy in traumatic brain injury: a clinical study.

Background: Intracranial pressure (ICP) monitoring represents an important tool in the management of traumatic brain injury (TBI). Although current information exists regarding ICP monitoring in secondary decompressive craniectomy (DC), little is known after primary DC following emergency hematoma evacuation.

Methods: Retrospective analysis of prospectively collected data.

Low-Dose Intramuscular Diclofenac Sodium for Fever Control in Acute Brain Injury.

Objective: To evaluate the cerebral and hemodynamic effects of low-dose intramuscular diclofenac sodium (DCFS) administered for fever control in patients with acute brain injury in the intensive care unit.

Methods: Inclusion criteria for this prospective clinical study were age ≥18 years; the ability to monitor intra-arterial blood pressure, core body temperature, and intracranial pressure; the placement of an indwelling jugular venous catheter for intermittent jugular venous oxygen saturation measurements; and a core body temperature ≥37.5°C.

Delayed Fever and Neurological Outcome after Cardiac Arrest: A Retrospective Clinical Study.

Background: The aim of this study was to evaluate the association between fever after the first days of ICU stay and neurological outcome after cardiac arrest (CA).

Methods: We retrospectively analyzed CA patients admitted to intensive care unit (ICU).

Inclusion Criteria: age ≥18 years, Glasgow Coma Scale score ≤8 at ICU admission and assessment of body core temperature (BCT) using bladder or intravascular probes.

Intravenous paracetamol for fever control in acute brain injury patients: cerebral and hemodynamic effects.

Background: Fever occurs frequently in acute brain injury patients, and its occurrence is associated with poorer outcomes. Paracetamol, an antipyretic frequently employed in patients with cerebral damage, may cause hypotension. We evaluated the cerebral and hemodynamic effects of intravenous (IV) paracetamol for the control of fever in Neuro-Intensive Care Unit (NICU) patients.

Intra-hospital transport of brain-injured patients: a prospective, observational study.

Introduction: Discrepant data exist regarding the incidence and severity of clinical problems related to intra-hospital transport of brain-injured patients and no consensus exists whether modern-day intra-hospital transport represents a safe or potentially problematic environment for neurointensive care unit (NICU) patients.

Methods: We examined the incidence of clinical complications and physiological derangements that occurred in 160 neurologically injured patients (90 males, 70 females, mean age 57 ± 17 years) who underwent intra-hospital transport (288 cases, 237 scheduled, 51 unscheduled) for computed tomography scans.

Results: Our findings indicate that (1) at least one significant complication (predominantly hemodynamic) occurred in over one-third (36%) of all transports (p = n.

Acute respiratory distress syndrome, the critical care paradigm: what we learned and what we forgot.

In the last several years, we definitely learned that the acute respiratory distress syndrome lung is small, nonhomogeneous, and that mechanical ventilation in this baby lung may cause physical damage as well as inflammatory reaction. The clinical benefit of the gentle lung treatment, based on a decrease of global/regional stress and strain into the lung, has been finally proved. However, we forgot the importance of lung perfusion and its distribution in this syndrome and, besides a low tidal volume, we still do not know how to handle the other variables of mechanical ventilation.

A complication of amiodarone infusion.

A 76-year-old man underwent an emergency laparotoray for a ruptured abdominal aortic ancurysm After a few days he presented ischemia of the left side of the colon and subsequently atrial fibrillation developed that was treated with Amiodarone. After an intravascular loading dose of 300 mg, he received a maintenance dose of 600 mg daily through a central line access. After 28 days of intravascular drug therapy, a chest X-ray showed a high attenuation homogeneous image in the right part of the mediastinum.