Management of acute respiratory distress syndrome using pumpless extracorporeal lung assist.

Purpose: To describe the use of a pumpless extracorporeal lung assist device in the treatment of severe acute respiratory distress syndrome (ARDS).

Clinical Features: A 15-yr-old girl developed severe post-traumatic ARDS. After all conventional treatment strategies failed, we inserted a pumpless extracorporeal lung assist device.

Dexmedetomidine infusion without loading dose in surgical patients requiring mechanical ventilation: haemodynamic effects and efficacy.

We investigated the haemodynamic effects and the efficacy of a continuous infusion of dexmedetomidine without a loading dose in 50 patients having had cardiac surgery (n = 33), complex major surgery (n = 9) and multiple trauma (n = 8). The mean age was 60 (+/- 16) years, and the mean APACHE II score was 13 (+/- 5). Dexmedetomidine was commenced at an initial rate of 0.

Dexmedetomidine infusion for more than 24 hours in critically ill patients: sedative and cardiovascular effects.

Objective: To assess the potential of dexmedetomidine for targeted sedation in complex Intensive Care (ICU) patients for >24 h.

Design: Prospective, open label, clinical trial.

Setting: Tertiary general ICU.

Gastric intramucosal pH as a monitor of gut perfusion after thrombosis of the superior mesenteric vein.

Gastric intramucosal pH (pHi) when measured by a tonometer is a simple and minimally invasive method to determine gut ischemia. In a case of severe mesenteric venous thrombosis, we measured pHi intra- and postoperatively over a period of five days. The goal was to monitor improvement or deterioration of gastrointestinal perfusion in the intensive care unit and to perform a second-look laparotomy if the condition worsened.