27 research outputs found
Positron annihilation in metals: A contribution to the analysis of angular correlation measurements, with an application to copper
No full textApplied Science
Sederende medicatie bij de geriatrische intensivecarepatient
No full textThe number of elderly patients admitted to Intensive Care Units (ICUs) has increased significantly in recent years. It has been demonstrated that the elderly are more prone to inadequate drug treatment and adverse drug effects. OBJECTIVE To perform a literature review on the effects of aging on pharmacokinetic and pharmacodynamic properties of commonly used sedative drugs in Dutch ICUs. DESIGN AND METHODS Literature review using PubMed. RESULTS Literature on the effects of aging on the pharmacology of commonly used sedative drugs in the ICU is scarce. For the general population, we found that for midazolam, propofol, fentanyl and remifentanil aging is associated with an increased susceptibility of the patients for the pharmaco-dynamic properties of these agents. This effect is confirmed for some of these drugs in ICU patients. In addition, a reduction in drug clearance was observed for propofol and remifentanil. CONCLUSION Based on these findings, we suggest to start with lower dosages for midazolam, propofol, fentanyl and remifentanil in elderly ICU patients and to re-evaluate frequently and adjust the therapy by clinical effect if necessary
Sedative drugs in the geriatric intensive care patient
No full textThe number of elderly patients admitted to Intensive Care Units (ICUs) has increased significantly in recent years. It has been demonstrated that the elderly are more prone to inadequate drug treatment and adverse drug effects. OBJECTIVE To perform a literature review on the effects of aging on pharmacokinetic and pharmacodynamic properties of commonly used sedative drugs in Dutch ICUs. DESIGN AND METHODS Literature review using PubMed. RESULTS Literature on the effects of aging on the pharmacology of commonly used sedative drugs in the ICU is scarce. For the general population, we found that for midazolam, propofol, fentanyl and remifentanil aging is associated with an increased susceptibility of the patients for the pharmaco-dynamic properties of these agents. This effect is confirmed for some of these drugs in ICU patients. In addition, a reduction in drug clearance was observed for propofol and remifentanil. CONCLUSION Based on these findings, we suggest to start with lower dosages for midazolam, propofol, fentanyl and remifentanil in elderly ICU patients and to re-evaluate frequently and adjust the therapy by clinical effect if necessary.</p
Patient recollection of airway suctioning in the ICU: routine versus a minimally invasive procedure
No full textEndotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial
No full textSedative drugs in the geriatric intensive care patient
No full textThe number of elderly patients admitted to Intensive Care Units (ICUs) has increased significantly in recent years. It has been demonstrated that the elderly are more prone to inadequate drug treatment and adverse drug effects. OBJECTIVE To perform a literature review on the effects of aging on pharmacokinetic and pharmacodynamic properties of commonly used sedative drugs in Dutch ICUs. DESIGN AND METHODS Literature review using PubMed. RESULTS Literature on the effects of aging on the pharmacology of commonly used sedative drugs in the ICU is scarce. For the general population, we found that for midazolam, propofol, fentanyl and remifentanil aging is associated with an increased susceptibility of the patients for the pharmaco-dynamic properties of these agents. This effect is confirmed for some of these drugs in ICU patients. In addition, a reduction in drug clearance was observed for propofol and remifentanil. CONCLUSION Based on these findings, we suggest to start with lower dosages for midazolam, propofol, fentanyl and remifentanil in elderly ICU patients and to re-evaluate frequently and adjust the therapy by clinical effect if necessary.</p
Stability issues in German money multiplier forecasts
No full textThis paper investigates the stability of the German money supply focusing on the period 1991 - 1998. It is shown that the standard ARIMA-Transfer model approach in the literature needs to be augmented by a cointegration term to adequately model the dynamics of money supply in Germany. Additional analysis with regard to the influence of financial innovations on the control of money supply yields evidence that the influence of financial innovations on the multiplier has increased steadily during the observation period. --Money Supply,Financial Innovation,Forecasting Money Multiplier
Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial
No full textStudy objective: Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in duration of intubation, length of stay in the ICU, and ICU mortality. Design: Randomised prospective clinical trial. Setting. In two ICUs at University Hospital Groningen, the Netherlands. Patients: Three hundred and eighty-three patients requiring endotracheal intubation for more than 24 h. Interventions: Routine endotracheal suctioning (n=197) using a 49-cm suction catheter was,compared with on-demand minimally invasive airway suctioning (n=186) using a suction catheter only 29 cm long. Measurements and results: No differences were found between the routine endotracheal suctioning group and the minimally invasive airway suctioning group in duration of intubation [median (range) 4 (1-75) versus 5 (1-101) days], ICU-stay [median (range) 8 (1-133) versus 7 (1-221) days], ICU mortality (15% versus 17%), and incidence of pulmonary infections (14% versus 13%). Suction-related adverse events occurred more frequently with RES interventions than with MIAS interventions; decreased saturation: 2.7% versus 2.0% (P=0.010); increased systolic blood pressure 24.5% versus 16.8% (
Fluid Resuscitation in Septic Patients Improves Systolic but not Diastolic Middle Cerebral Artery Flow Velocity
No full textTo investigate the effects of fluid resuscitation on cerebral hemodynamics in sepsis, the following set of transcranial Doppler (TCD) parameters was used: maximal change in flow velocity (FV) during stroke onset (acc), maximal FV during first (sys1) or second (sys2) phase of systole and mean diastolic FV (dias@560). We aim to evaluate changes in cerebral hemodynamics that result from (i) sepsis and (ii) adequate fluid resuscitation in critically ill septic patients. In the majority of 16 septic patients sys2 was initially absent but reappeared during the period of fluid resuscitation; whereas sys2 absence was never seen in healthy controls. Second, adequate fluid resuscitation resulted in a significant increase of the systolic FV components (acc, sys1, sys2 and systolic blood pressure); whereas the diastolic components (dias@560 and diastolic blood pressure) remained unchanged. Sys2 absence and reappearance in sepsis suggests that TCD could become a non-invasive alternative for hemodynamic monitoring
Systemic VEGF levels after coronary artery bypass graft surgery reflects the extent of inflammatory response
No full textBACKGROUND: Circulating vascular endothelial growth factor (VEGF) was studied as a substitute endpoint for treatment response after VEGF plasmid therapy. The effect of coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB) on systemic VEGF levels are however largely unknown, therefore, we studied the effect of this procedure to measure VEGF levels after surgery alone. METHODS: Fourteen patients requiring CABG were included. VEGF165 levels, ischemic markers, and hematology were measured before, directly after six days after surgery. RESULTS: VEGF165 in serum and whole blood levels were increased up to six days after CABG, respectively 249.6(plus or minus)50.4 to 451.7(plus or minus)56.4 (day 6) and 581.9(plus or minus)105.1 to 783.4(plus or minus)97.7 (day six). There was a close correlation of circulating VEGF165 with leukocyte counts and platelets and not with ischemic markers. CONCLUSION: Following surgery and in case of activated leukocyte and platelet counts care must be taken in the interpretation of systemic VEGF165 levels. (copyright) 2006 Taylor & Franci
