Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Crit Care Med ; 33(11): 2451-6, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16276165

RESUMO

OBJECTIVE: Acute renal failure is common in septic patients. Fenoldopam, a dopamine-1 receptor agonist, increases renal blood flow and may, therefore, reduce the risk of acute renal failure in such patients. Accordingly, we sought to determine the safety and efficacy of fenoldopam for the prevention of acute renal failure in septic patients. DESIGN: Prospective, double-blind, placebo-controlled trial. SETTING: Three multidisciplinary intensive care units at a university hospital. PATIENTS: Three hundred septic patients with baseline serum creatinine concentrations <150 micromol/L. INTERVENTIONS: We randomized patients to a continuous infusion of either fenoldopam (n = 150) at 0.09 microg x kg x min or placebo (n = 150) while in the intensive care unit. The primary outcome measure was the incidence of acute renal failure, defined as a serum creatinine concentration increase to >150 micromol/L, during study drug infusion. MEASUREMENTS AND MAIN RESULTS: The incidence of acute renal failure was significantly lower in the fenoldopam group compared with the control group (29 vs. 51 patients; p = .006). The odds ratio of developing acute renal failure for patients treated with fenoldopam was estimated to be 0.47 (p = .005). The difference in the incidence of severe acute renal failure (creatinine >300 mumol/L), however, failed to achieve statistical significance (10 vs. 21; p = .056). The length of intensive care unit stay in surviving patients was significantly lower in the fenoldopam group compared with the control group (10.64 +/- 9.3 vs. 13.4 +/- 14.0; p < .001). There were no complications of fenoldopam infusion. A direct effect of treatment on the probability of death, beyond its effect on acute renal failure, was not significant (odds ratio = 0.68, p = .1). CONCLUSIONS: Compared with placebo, low-dose fenoldopam resulted in a smaller increase in serum creatinine in septic patients. The clinical significance of this finding is uncertain. A large multiple-center trial is now needed to confirm these findings.


Assuntos
Injúria Renal Aguda/prevenção & controle , Agonistas de Dopamina/uso terapêutico , Fenoldopam/uso terapêutico , Injúria Renal Aguda/etiologia , Creatinina/sangue , Método Duplo-Cego , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Sepse/complicações
2.
Chir Ital ; 54(3): 409-15, 2002.
Artigo em Italiano | MEDLINE | ID: mdl-12192942

RESUMO

A multidisciplinary approach to severe polytraumatized patient is very important for a rapid, uncomplicated recovery. Specialized centres with special beds, monitoring equipment, and a multidisciplinary team are required. The authors report a case of a 26-year-old man admitted to their department in an emergency setting for a crush injury (occupational trauma) of the lumbar, gluteal and perineal areas, complicated with septic shock and gas gangrene of the injured areas. A multidisciplinary approach to the patient, consisting in surgical and plastic surgical therapy, hyperbaric oxygen therapy and the use of a special antidecubitus fluidized bed allowed complete recovery within 7 months without any motor or sphincter disorders.


Assuntos
Traumatismo Múltiplo/terapia , Centros de Traumatologia , Acidentes de Trabalho , Adulto , Gangrena Gasosa/terapia , Humanos , Oxigenoterapia Hiperbárica , Masculino , Traumatismo Múltiplo/psicologia , Úlcera por Pressão/prevenção & controle , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...