Continuous positive airway pressure for treatment of postoperative hypoxemia: a randomized controlled trial.

Context: Hypoxemia complicates the recovery of 30% to 50% of patients after abdominal surgery; endotracheal intubation and mechanical ventilation may be required in 8% to 10% of cases, increasing morbidity and mortality and prolonging intensive care unit and hospital stay.

Objective: To determine the effectiveness of continuous positive airway pressure compared with standard treatment in preventing the need for intubation and mechanical ventilation in patients who develop acute hypoxemia after elective major abdominal surgery.

Design And Setting: Randomized, controlled, unblinded study with concealed allocation conducted between June 2002 and November 2003 at 15 intensive care units of the Piedmont Intensive Care Units Network in Italy.

Regional citrate anticoagulation in critically ill patients treated with plasma filtration and adsorption.

Background: In high-risk bleeding conditions conventional systemic anticoagulation with heparin is a contraindication to renal replacement therapy. We evaluate the feasibility and safety of regional citrate anticoagulation in high-risk bleeding conditions during coupled plasma filtration adsorption (CPFA).

Methods: Thirteen critically ill patients (9 severely burned, 4 polytraumas) with septic shock and acute renal failure treated with CPFA-CVVHD by using bicarbonate-based solutions (heparin-CPFA group, 58 sessions) or with CPFA-CVVHF using citrate (citrate-CPFA group, 36 sessions).

Physiological effects of translaryngeal open ventilation in patients with restrictive respiratory disorders.

Objective: To compare the efficacy of pressure-controlled ventilation (PCV) delivered through a conventional endotracheal tube with the same ventilatory mode using a small-size tube with the cuff left deflated (translaryngeal open ventilation: TLOV).

Setting: A medical-surgical intensive care unit (ICU).

Design: Prospective physiological study.