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IntensiveMedizin.80350382.eng.abstr
|
IntensiveMedizin.80350382.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350382.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abnormal bleeding has long been recognized as a common and potentially serious complication of acute and chronic renal failure of different etiologies . Both vascular and platelet abnormalities seem to concur to the bleeding diathesis in chronic uremia . Dialysis and the modern management of renal failure have considerably reduced the occurrence of severe hemorrhages in patients with chronic uremia ; at present the major bleeding manifestations consist in ecchymoses , epistaxis , and , only occasionally , gastrointestinal bleeding , hemopericardium , or subdural hematoma . Bleeding can still occur as a severe complication following surgery or biopsy . This review will first analyze the causes of uremic bleeding and will then discuss the therapeutic intervention ."
],
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[
0,
773
]
]
}
] |
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"etiologies"
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"id": "IntensiveMedizin.80350382.eng.abstr-s1-t3",
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"renal failure"
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{
"id": "IntensiveMedizin.80350382.eng.abstr-s1-t4",
"type": "umlsterm",
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"chronic renal failure"
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"id": "IntensiveMedizin.80350382.eng.abstr-s2-t1",
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"platelet"
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"id": "IntensiveMedizin.80350382.eng.abstr-s2-t2",
"type": "umlsterm",
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"abnormalities"
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"id": "IntensiveMedizin.80350382.eng.abstr-s2-t3",
"type": "umlsterm",
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"diathesis"
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"id": "IntensiveMedizin.80350382.eng.abstr-s2-t4",
"type": "umlsterm",
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"uremia"
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"id": "IntensiveMedizin.80350382.eng.abstr-s2-t5",
"type": "umlsterm",
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"chronic uremia"
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238,
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"id": "IntensiveMedizin.80350382.eng.abstr-s3-t1",
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"Dialysis"
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"id": "IntensiveMedizin.80350382.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"occurrence"
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{
"id": "IntensiveMedizin.80350382.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"hemorrhages"
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"type": "umlsterm",
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"type": "umlsterm",
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"uremia"
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{
"id": "IntensiveMedizin.80350382.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"ecchymoses"
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"db_id": "C0013491"
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{
"id": "IntensiveMedizin.80350382.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"epistaxis"
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},
{
"id": "IntensiveMedizin.80350382.eng.abstr-s3-t8",
"type": "umlsterm",
"text": [
"hemopericardium"
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"id": "IntensiveMedizin.80350382.eng.abstr-s3-t9",
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"hematoma"
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"id": "IntensiveMedizin.80350382.eng.abstr-s3-t10",
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"renal failure"
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"id": "IntensiveMedizin.80350382.eng.abstr-s3-t11",
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"chronic uremia"
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"id": "IntensiveMedizin.80350382.eng.abstr-s3-t12",
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"id": "IntensiveMedizin.80350382.eng.abstr-s3-t13",
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[] |
[] |
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IntensiveMedizin.80350390.eng.abstr
|
IntensiveMedizin.80350390.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350390.eng.abstr-passage-0",
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"text": [
"The hepatorenal syndrome is defined as the development of renal failure in patients with severe liver disease in the absence of any other identifiable cause of renal functional impairment . The pathogenesis of this obviously functional renal failure is complex and not completely understood . Of importance seems to be a peripheral and systemic vasodilatation with redistribution of blood volume . Nitric oxide seems to play a major role as a possible primary mediator . As a consequence changes in several different pathophysiological mechanisms ( sympathetic nervous system , renin-angiotensin system , vasopressin , endothelin , prostanoids , natriuretic peptides ) lead to a functional renal impairment which is characterized by renal cortical vasoconstriction . Supportive treatment and intensive monitoring of the cardiovascular circulation is the main goal in the care of these patients . The mortality is still high exceeding 90% . Renal extracorporeal support should be initiated using a continuous method when recovery of liver function is expected ( acute liver failure , waiting for liver transplantation ) . The only effective and permanent treatment is orthotopic liver transplantation ."
],
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1201
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]
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IntensiveMedizin.80350401.eng.abstr
|
IntensiveMedizin.80350401.eng.abstr
|
[
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"id": "IntensiveMedizin.80350401.eng.abstr-passage-0",
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"text": [
"The endoscopic guided puncture tracheostomy has established itself in many intensive care units . Manufacturers offer complete tracheostomy kits , based on the described techniques from Ciaglia ( Cook-Set ) , as well as from Griggs ( Portex-Set ) . The goal of this investigation was to show the advantages , disadvantages , costs and risks of the puncture tracheostomy and to make a comparison using conventional procedures ."
],
"offsets": [
[
0,
426
]
]
}
] |
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] |
[] |
[] |
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] |
IntensiveMedizin.80350408.eng.abstr
|
IntensiveMedizin.80350408.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350408.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Background : Evacuation of hemodynamically compromising pericardial effusion should be performed using intensive care facilities . If hemorrhagic fluid is aspired , it is difficult to distinguish cardiac or vascular damage from hemorrhagic effusion . Several methods of proving the correct position of the needle have been recommended , e.g. , injection of radiopaque contrast medium or determination of the hemoglobin level . Methods : In 10 patients with hemorrhagic pericardial effusion , most of them having malignancies , pericardiocentesis was performed under echocardiographic guidance from a subxiphoid approach with the patient's chest tilted up app . 30 ° . When hemorrhagic fluid was aspirated , 3 to 5 ml of d-galactose ( Echovist-200, Schering AG , Berlin ) was injected . The distribution in the pericardial effusion was followed echocardiographically . If the needle position was correct , a sheath and a pigtail catheter F5 were inserted over a guide wire . Results : A mean of 546 ( 260-800 ) ml of effusion was removed . In one patient , the contrast medium was visualized within the right ventricle indicating an incorrect needle position . This could be corrected without sequelae . In one patient , loculated effusion required a second pericardiocentesis . Conclusions : Contrast echocardiographically guided pericardiocentesis using Echovist as a contrast medium is a fast and safe method of evacuating hemorrhagic pericardial effusions , which can be performed in a bedside fashion ."
],
"offsets": [
[
0,
1506
]
]
}
] |
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{
"id": "IntensiveMedizin.80350408.eng.abstr-s1-t2",
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"id": "IntensiveMedizin.80350408.eng.abstr-s3-t7",
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"id": "IntensiveMedizin.80350408.eng.abstr-s4-t3",
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"id": "IntensiveMedizin.80350408.eng.abstr-s4-t4",
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"id": "IntensiveMedizin.80350408.eng.abstr-s8-t3",
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{
"id": "IntensiveMedizin.80350408.eng.abstr-s12-t2",
"type": "umlsterm",
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"pericardiocentesis"
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{
"id": "IntensiveMedizin.80350408.eng.abstr-s13-t1",
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"Contrast"
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{
"id": "IntensiveMedizin.80350408.eng.abstr-s13-t2",
"type": "umlsterm",
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},
{
"id": "IntensiveMedizin.80350408.eng.abstr-s13-t3",
"type": "umlsterm",
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"Echovist"
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1355,
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"db_id": "C0115427"
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"id": "IntensiveMedizin.80350408.eng.abstr-s13-t4",
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{
"id": "IntensiveMedizin.80350408.eng.abstr-s13-t5",
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IntensiveMedizin.80350417.eng.abstr
|
IntensiveMedizin.80350417.eng.abstr
|
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"id": "IntensiveMedizin.80350417.eng.abstr-passage-0",
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"If one follows the concept of the \" golden hour \" in the treatment of myocardial infarction , it is not only a matter of intervention \" as soon as possible \" but also the attempt to remain in this critical time frame by gaining time . Also for patients , who alert the emergency medical system very early , this concept fails in practice , because the ambulance personnel often lack the quali-fications to recognise and treat patients with acute myocardial infarction early . With ECG transmission from the emergency location to the hospital and by wireless communication , this situation can be improved and critical time can be gained . The practical problems appear solvable . An acceptance for the process may , however only then be expected if the concept of a time frame for optimal treatment of myocardial infarction gains acceptance ."
],
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0,
842
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IntensiveMedizin.80350421.eng.abstr
|
IntensiveMedizin.80350421.eng.abstr
|
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{
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],
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573
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]
}
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[] |
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IntensiveMedizin.80350535.eng.abstr
|
IntensiveMedizin.80350535.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350535.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Cardiogenic shock is the leading cause of death in patients hospitalized with acute myocardial infarction . The typical delay from the onset of acute infarction to the development of cardiogenic shock and well defined risk factors allow for an early identification of patients at risk . Immediate restoration of coronary artery patency by thrombolysis or PTCA can prevent cardiogenic shock in a number of these patients . Patients presenting with frank cardiogenic shock should be approached with diagnostic vigor in an attempt to identify a treatable lesion . Several non-randomized studies suggest that PTCA is superior to thrombolysis in patients with shock and ongoing ischemia . However , aortic counterpulsation may enhance reperfusion rates achieved by thrombolytic therapy in patients with cardiogenic shock . Early surgery is required in patients with shock due to mechanical complications , such as acute mitral regurgitation or rupture of the ventricular septum . Ventricular assist devices can be used in selected patients with refractory shock as a bridge to cardiac transplantation ."
],
"offsets": [
[
0,
1097
]
]
}
] |
[
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"text": [
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IntensiveMedizin.80350543.eng.abstr
|
IntensiveMedizin.80350543.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350543.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute heart failure consists of decompensated chronic heart failure , acute pulmonary edema and cardiogenic shock . While decompensated heart failure shows little therapeutic difficulties therapy of pulmonary edema is more sophisticated . Cardiogenic shock , however is still a therapeutic challenge . For therapy of cardiogenic shock positive inotropes , phosphodiesterase-inhibitors and various assist devices are currently in use . If it is not possible to correct underlying diseases , mortality of cardiogenic shock is still high ."
],
"offsets": [
[
0,
536
]
]
}
] |
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"id": "IntensiveMedizin.80350543.eng.abstr-s2-t5",
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] |
IntensiveMedizin.80350548.eng.abstr
|
IntensiveMedizin.80350548.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350548.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute cardiac ischemic syndromes represent a continuous spectrum of disease with the same underlying cause : rupture or fissuring of a stable atheromatous plaque to form an unstable lesion with superimposed thrombus formation . Angioscopic findings show that in patients with unstable angina the thrombus is white or gray and probably consists mostly of platelets . Platelet adhesion , activation and aggregation are central to the pathophysiology of unstable angina . Pharmacological antagonism of this process is thus an attractive strategy for antithrombotic therapy . Aspirin , Ticlopidine and Clopidogrel inhibit platelet aggregation and have been shown to decrease the frequency of clinical events . However these drugs provide only partial inhibition of platelet aggregation and they do not inhibit the stimulation of platelet aggregation by agonists such as thrombin . Inhibition of the final common pathway of platelet aggregation , with the glycoprotein IIb/IIIa receptor as a target , offers a logical method of achieving greater control of platelet function . Several inhibitors of glycoprotein IIb/IIIa receptors have been evaluated for use in patients undergoing coronary angioplasty and in those with unstable angina . This article will review the results of clinical trials evaluating the GP IIb/IIIa inhibitors in the settings of PTCA and unstable angina , and provide a critical discussion on the role of this new class of drugs in the management of patients with ischemic coronary syndromes ."
],
"offsets": [
[
0,
1511
]
]
}
] |
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IntensiveMedizin.80350557.eng.abstr
|
IntensiveMedizin.80350557.eng.abstr
|
[
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"In recent years a multitude of reports has been published on the effects of various antiarrhythmic and non-antiarrhythmic drugs causing QT-intervall prolongation and thus triggering a characteristic form of polymorphic ventricular tachycardia known as torsade de pointes . These drugs included antiarrhythmics , antibiotics , antifungals , prokinetics and various other substances which often cause QT-prolongation and torsades only in combination with other riskfactors such as hypokalaemia or bradycardia . Most of these substances block the delayed rectifier potassium channel in myocytes . In this review we summarized the current knowledge on electrophysiologic mechanisms , riskfactors , arrhythmogenic risk and therapy of the acquired long-QT syndrome ."
],
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[
0,
760
]
]
}
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{
"id": "IntensiveMedizin.80350557.eng.abstr-s4-t5",
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[] |
[] |
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}
] |
IntensiveMedizin.80350565.eng.abstr
|
IntensiveMedizin.80350565.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350565.eng.abstr-passage-0",
"type": "abstract",
"text": [
"With increasing success , mechanical circulatory assist is used in cardiological and cardiosurgical intensive care . Its primary goal is to maintain circulation in the state of terminal cardiac failure which cannot be stabilized otherwise . By means of mechanical support , perfusion can be provided to vital organs in order to prevent or at least limit irreversible damage ."
],
"offsets": [
[
0,
375
]
]
}
] |
[
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{
"id": "IntensiveMedizin.80350565.eng.abstr-s1-t2",
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{
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{
"id": "IntensiveMedizin.80350565.eng.abstr-s2-t2",
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{
"id": "IntensiveMedizin.80350565.eng.abstr-s3-t1",
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[
274,
283
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0031001"
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] |
[] |
[] |
[
{
"id": "IntensiveMedizin.80350565.eng.abstr-s1-r1-t1.1-t3.1",
"type": "isa",
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IntensiveMedizin.80350574.eng.abstr
|
IntensiveMedizin.80350574.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350574.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Cytokines and their endogenous antagonists are released from inflammatory cells during acute pancreatitis . The role of cytokines in the initiation of acute pancreatitis has been examined in animal models but also in patients using the post-ERP pancreatitis model . Cytokine release was followed by an anti-cytokine release . Serum levels of cytokines correlate well with the severity of the pancreatitis and may be useful as prognostic parameters . However , clinical scores as well as PMN elastase are established in determining prognosis . Anti-inflammatory cytokines , like IL-10 or soluble antagonists/receptors of IL-1 und TNF- may be promising mediators in the treatment of acute pancreatitis as demonstrated in animal experiments . However , clinical trials are necessary to confirm these promising anticytocine therapeutic strategies ."
],
"offsets": [
[
0,
844
]
]
}
] |
[
{
"id": "IntensiveMedizin.80350574.eng.abstr-s1-t1",
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],
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0,
9
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],
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{
"id": "IntensiveMedizin.80350574.eng.abstr-s1-t2",
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"antagonists"
],
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[
31,
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],
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},
{
"id": "IntensiveMedizin.80350574.eng.abstr-s1-t3",
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"text": [
"cells"
],
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[
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"db_id": "C0007634"
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]
},
{
"id": "IntensiveMedizin.80350574.eng.abstr-s1-t4",
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"text": [
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IntensiveMedizin.80350593.eng.abstr
|
IntensiveMedizin.80350593.eng.abstr
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[
{
"id": "IntensiveMedizin.80350593.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute aortic dissection is an emergency situation , and the diagnosis must be confirmed as soon as possible because of high early mortality . Severe , persistent chest pain of sudden onset is characteristic . Transesophageal echocardiography , computed tomography , magnetic resonance imaging , and aortography have comparable diagnostic accuracy with advantages and disadvantages , which are discussed in this overview . Echocardiography in aortic dissection can detect an intimal flap , intimal tears , the true and false lumen , complications such as pericardial and pleural effusions , aortic insufficiency , and involvement of the coronary arteries . Treatment includes the hemodynamic stabilization , simultaneous reduction of the systolic blood pressure , and reduction of the pulsatile aortic flow ( shear stress ) . All acute dissections involving the ascending aorta should be treated promptly with surgery . For dissections arising in the descending aorta , surgical treatment may be delayed until the hypertension and dissection have been stabilized . Permanent medical treatment may be offered in patients with type B dissections which tend to be poor surgical risks ."
],
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[
0,
1181
]
]
}
] |
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[] |
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IntensiveMedizin.80350599.eng.abstr
|
IntensiveMedizin.80350599.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350599.eng.abstr-passage-0",
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"text": [
"Objective : To evaluate the performance of the Simplified Acute Physiology Score ( SAPSII ) in patients with acute myocardial infarction ( AMI ) . Background : Scores are used to describe and stratify groups of critically ill patients according to severity of disease and prognosis . Coronary care patients were excluded from the developmental and validation samples of the original score . Therefore , discrimination and calibration of SAPS II have to be evaluated in this group of patients . Methods : SAPSII , risk of death , and outcome of hospital treatment ( surviving , dead ) were recorded in all 592 patients with AMI treated in the ICU of our community teaching hospitel since routine implementation of SAPSII . ROC curves and area under curve ( AUC ) were calculated to evaluate discrimination power . A formal goodness-of-fit test was performed and a calibration curve calculated to evaluate calibration . Results : In 592 pat . with AMI , the mean age was 65.8 +/- 12.6 y , SAPSII 30.7 +/- 17.1 , risk of death , median 6.4% ( 25 ; 75% percentile 2.7% ; 14.8% ) , mortality in the ICU 10.3% , hospital mortality 14.5% . Standardized mortality index was 0.89 ( 0.77- 1.05 ; 99% confidence intervall ) . The AUC of ROC for risk of death was 0.868 +/- 0.021. Chi2 was 13.15 and the P value 0.2 for the goodness-of-fit test . The calibration curve showed no significant deviation from the line of identity . The higher hospital mortality of females ( 19.2 versus 12.4 in men ) was in accordance with a higher SAPSII score and a higher risk of death , which is mainly explained by the higher age of females with AMI . Conclusion : SAPS had a strong discrimination power and a satisfactory calibration performance in patients with AMI . SAPSII can be applied to groups of ICU patients with AMI ."
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] |
[] |
[] |
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},
{
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}
] |
IntensiveMedizin.80350607.eng.abstr
|
IntensiveMedizin.80350607.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350607.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The aim of this prospective study was to assess the clinical and prognostic relevance of patent foramen ovale - in contrast to risk factors for atherosclerosis and cardioembolic sources - in 208 patients with cerebral ischemic events . All patients underwent neurological examination ( Doppler , CT , NMR ) as well as transthoracic and transesophageal echocardiography . A patent foramen ovale was found in 75 patients ( 36% ) . With regard to risk factors for atherosclerosis patients with closed resp. patent foramen ovale revealed significant differencies for age , hypertension , diabetes and use of oral contraceptives . Cardioembolic sources showed significant differencies for atrial fibrillation and atrial septal aneurysm . Multivariate analysis of risk factors for atherosclerosis and cardioembolic sources revealed hypertension and diabetes as age dependant risk factors in patients with closed foramen ovale . In patients with patent foramen ovale the use of oral contraceptives was found as an independant risk factor for cerebral ischemic event . Patients > 60 years with cerebral ischemic events had more often a closed foramen ovale . Dependant on age patients with closed foramen ovale showed a higher frequency of hypertension and diabetes . In addition these patients revealed more often atrial fibrillation . Patients with patent foramen ovale had fewer risk factors for atherosclerosis or cardioembolic sources but presented more frequent the use of oral contraceptives or atrial septal aneurysm ."
],
"offsets": [
[
0,
1518
]
]
}
] |
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"id": "IntensiveMedizin.80350607.eng.abstr-s1-t10",
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"id": "IntensiveMedizin.80350607.eng.abstr-s2-t4",
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"id": "IntensiveMedizin.80350607.eng.abstr-s3-t3",
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"id": "IntensiveMedizin.80350607.eng.abstr-s3-t4",
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"id": "IntensiveMedizin.80350607.eng.abstr-s4-t12",
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},
{
"id": "IntensiveMedizin.80350607.eng.abstr-s7-t4",
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"id": "IntensiveMedizin.80350607.eng.abstr-s7-t9",
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IntensiveMedizin.80350620.eng.abstr
|
IntensiveMedizin.80350620.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350620.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The relative success of thrombolytic versus surgical therapy of thrombus in transit has not yet been evaluated in clinical studies . Only case reports of one or more patients exist . Optimal therapy , therefore , remains controversial , and conclusive recommendations in favor of one choice of therapy over the other cannot be given . Nevertheless , in current practice thrombolysis as a noninvasive and quickly available form of therapy is preferred , if no contraindications exist . Two cases are presented together with a literature review ."
],
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0,
544
]
]
}
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"id": "IntensiveMedizin.80350620.eng.abstr-s1-t5",
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}
]
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"id": "IntensiveMedizin.80350620.eng.abstr-s3-t2",
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252,
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] |
[] |
[] |
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{
"id": "IntensiveMedizin.80350620.eng.abstr-s3-r7-t1.1-t2.1",
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{
"id": "IntensiveMedizin.80350620.eng.abstr-s4-r1-t2.1-t1.1",
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"normalized": []
}
] |
IntensiveMedizin.80350625.eng.abstr
|
IntensiveMedizin.80350625.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350625.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Diagnosis of an entrapped thrombus in a patent foramen ovale without preceding arterial embolism is rare . We report an intensive care patient in whom TEE was performed because pulmonary embolism was suspected . Surprisingly , the examination not only confirmed the suspicion of pulmonary embolism , but also revealed an elongated highly mobile mass overriding a patent foramen ovale , with large parts protruding both into the left and the right atrium . This was suspected to be of thromboembolic origin . The patient underwent emergent surgery which confirmed the initial diagnosis , and embolectomy of a 19 cm giant thrombus was performed successfully . Diagnosis of the entrapped thrombus by TEE led to immediate therapeutic intervention preventing further pulmonary or paradoxical embolism ."
],
"offsets": [
[
0,
797
]
]
}
] |
[
{
"id": "IntensiveMedizin.80350625.eng.abstr-s1-t1",
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0,
9
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]
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{
"id": "IntensiveMedizin.80350625.eng.abstr-s1-t2",
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"thrombus"
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26,
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"db_id": "C0087086"
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"id": "IntensiveMedizin.80350625.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"patent"
],
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40,
46
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"id": "IntensiveMedizin.80350625.eng.abstr-s1-t4",
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"embolism"
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"id": "IntensiveMedizin.80350625.eng.abstr-s1-t5",
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"id": "IntensiveMedizin.80350625.eng.abstr-s2-t3",
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187,
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"id": "IntensiveMedizin.80350625.eng.abstr-s2-t5",
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"id": "IntensiveMedizin.80350625.eng.abstr-s3-t1",
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"id": "IntensiveMedizin.80350625.eng.abstr-s3-t2",
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{
"id": "IntensiveMedizin.80350625.eng.abstr-s3-t3",
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"right"
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{
"id": "IntensiveMedizin.80350625.eng.abstr-s3-t4",
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"atrium"
],
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447,
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{
"id": "IntensiveMedizin.80350625.eng.abstr-s3-t5",
"type": "umlsterm",
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"pulmonary embolism"
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279,
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"id": "IntensiveMedizin.80350625.eng.abstr-s3-t6",
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"id": "IntensiveMedizin.80350625.eng.abstr-s3-t7",
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"right atrium"
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441,
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{
"id": "IntensiveMedizin.80350625.eng.abstr-s3-t8",
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"patent foramen ovale"
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"id": "IntensiveMedizin.80350625.eng.abstr-s4-t1",
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"id": "IntensiveMedizin.80350625.eng.abstr-s5-t1",
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"patient"
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{
"id": "IntensiveMedizin.80350625.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"surgery"
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"id": "IntensiveMedizin.80350625.eng.abstr-s5-t3",
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IntensiveMedizin.80350630.eng.abstr
|
IntensiveMedizin.80350630.eng.abstr
|
[
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"type": "abstract",
"text": [
"In this paper experiences with transtelephonic ECG transmission are reported . After patients have been instructed , they received a simple ECG recorder and transmitted the 9 or 12 lead ECG to the Central Monitoring Unit situated at the intensive care unit ( ICU ) of the community hospital . This hospital-based transtelephonic ECG surveillance center is served by experienced physicians on a 24 h basis . According to previous studies , this system proved reliable with a high predictive value . This analysis is concerned with patients monitored about one year . Most of the ECG calls were done within the first sixth months . As patients could be immediately advised by a physician of the ICU after sending their ECG and reporting their symptoms , a lot of emergency treatments ( emergency car equipped with an emergency physician ) could be avoided . Acute ischemic events and arrhythmias could reliably detected , these patients had been referred to their general practitioner or , if necessary , recommended to see the emergency room at the hospital . To date , there are some more projects with telephonic ECG transmission , such as transmission from airplane or from remote tourist places or from the mobile emergency unit . New development will take place in the near future such as transmission of several more biological signals ( ECG , oxygen saturation , blood pressure ) in combination with the patients medical file via a small card . This then would reduce costs in emergency medicine , if health care providers will acknowledge and accept these procedures ."
],
"offsets": [
[
0,
1575
]
]
}
] |
[
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"id": "IntensiveMedizin.80350630.eng.abstr-s1-t2",
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"ECG"
],
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47,
50
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{
"id": "IntensiveMedizin.80350630.eng.abstr-s1-t3",
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[] |
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IntensiveMedizin.80350641.eng.abstr
|
IntensiveMedizin.80350641.eng.abstr
|
[
{
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"text": [
"As a non-invasive parameter QT dispersion has been investigated in different cardiovascular diseases and clinical conditions to demonstrate the ability of the method to predict ventricular arrhythmias and its clinical outcome , sudden cardiac death . Although various studies have shown significant QT dispersion in different patient groups , the method is still under discussion . QT dispersion has been extensively evaluated in ischemic heart disease showing frequently significant higher dispersion values in the infarction group compared to patients without cardiac diseases . Greatest QT dispersion values were reported from patients with susceptibility to ventricular tachyarrhythmias or ventricular fibrillation in whom QT dispersion exceeded the QT dispersion in post-infarction patients without ventricular arrhythmias . Additionally , in patients with inducible monomorphic ventricular tachycardia during electrophysiologic testing QT dispersion was significantly greater than in patients without inducibility . Patients with inherited long QT syndrome , dilative or hypertrophic cardiomyopathy and ventricular arrhythmias QT dispersion has been reported to be significantly higher compared to those who were normal controls or had no arrhythmic event . However the values showed high variations and the results were not always confirmed by others . The clinical significance of QT dispersion has also been investigated with antiarrhythmic drug treatment as a potential marker for prediction of unwanted proarrhythmic complications . A close relationship between the administration of class I A and I C antiarrhythmic drugs and increased QT dispersion has been shown especially when myocardial ischemia ( e . g . propafenone ) was present . Conversely , class III antiarrhythmic drugs ( amiodarone/sotalol ) had no negative effect on or even reduced QT dispersion ."
],
"offsets": [
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0,
1875
]
]
}
] |
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[] |
[] |
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IntensiveMedizin.80350647.eng.abstr
|
IntensiveMedizin.80350647.eng.abstr
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"Recent advances in the treatment of acute renal failure , e.g. , continuous hemofiltration or dialysis , provide excellent compensation of uremia even in unstable intensive care patients . The clearance required to stabilize plasma urea concentration on a desired level depends on body weight and on normalized protein catabolic rate ( nPCR ) . In a patient with 75 kg body weight and a nPCR of 1.5 g/kg/d , continuous dialysis providing an urea clearance of 25 ml/min results in a steady state urea concentration of 100 mg/dl . Using intermittent hemodialysis , daily treatment is required to achieve this excellent level of uremia compensation . Currently , there is no consensus as to desirable steady-state level of plasma urea in anuric intensive care patients . However , a randomized study recently demonstrated that the mortality rate in intensive care patients with acute renal failure dialyzed daily was half that of patients treated every other day . If a more intensive hemodialysis treatment improves outcome , initiation of hemodialysis has also to be reconsidered . Hemodialysis should be started as soon as the steady-state plasma concentration of urea desired during the treatment is exceeded ."
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IntensiveMedizin.80350680.eng.abstr
|
IntensiveMedizin.80350680.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350680.eng.abstr-passage-0",
"type": "abstract",
"text": [
"After acute renal injury , renal expression of several growth factors becomes transiently altered . The increased expression of some growth factors and/or their receptors at sites of nephron injury suggests important contributions of these peptides to the natural repair process . Exogenously administered IGF-I , EGF or HGF each have been shown to accelerate the recovery of renal function in animal models of acute renal failure . The mechanisms of action of these peptides in acute renal failure appear to include the resetting of the cell cycle clock by activating cyclin-dependent kinases inducing transition through the G1/S-restriction point , which results in mitosis . Growth factors support differentiation of newly formed tubular cells , down-regulate apoptosis , and improve renal hemodynamics . However , two recent clinical trials of rhIGF-I in acute renal failure had disappointing results . Although experimental data support the therapeutic utility of recombinant growth factors in acute renal failure , further experimental research and especially clinical trials are necessary ."
],
"offsets": [
[
0,
1097
]
]
}
] |
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[] |
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IntensiveMedizin.80350691.eng.abstr
|
IntensiveMedizin.80350691.eng.abstr
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"Objective : Evaluation of the scores APACHE II and III , SAPS II , and MPM II for risk stratification and quality control in patients of a German interdisciplinary intensive care unit ( ICU ) . Methods : The data of all consecutive patients of a 12 bed interdisciplinary intensive care unit were collected over a 12 month period . The score values and probabilities of hospital deaths were compared with observed outcomes . The discriminatory power was analyzed by calculating the areas under the receiver-operating characteristic ( ROC ) curves , calibration by standardized mortality ratios ( SMR ) , and goodness-of-fit statistic . Results : Of 1,000 admissions 96 were repeated ICU stays . Due to exclusion criteria of the scores 883 patients could be analyzed for APACHE II , 775 for APACHE III and SAPS II , and 638 for MPM II . Mean age was 61.5 ( 16-96 ) years , 67.2% were medical , 32.8% surgical admissions , 37.4% of those after emergency surgery . ICU stay lasted 3.9 days , hospital stay 26.4 days . ICU mortality was 7.6% , hospital mortality 17.2% . Areas under the ROC curves were calculated as 0.81 ( APACHE II ) , 0.82 ( APACHE III ) , and 0.83 ( SAPS II and MPM II ) . The SMR was 1.00 for APACHE II , 1.19 for APACHE II , 1.09 for SAPS II , and 0.99 for MPM II . Calibration was good for APACHE II ( chi-square 6 , p > 0.5 ) , SAPS II ( chi-square 9 , p > 0.3 ) , and MPM II ( chi-square 12 , p > 0.1 ) , but insufficient for APACHE III ( chi-square 19 , p 0.025 ) . Mortality ratios for various diagnostic groups differed as well as the pattern of the four score systems in different risk strata . Discussion : Discriminatory power of all four score systems was similar in our patients . Calibration was insufficient for APACHE III , but good for APACHE II , SAPS II , and MPM II . These three systems could be used for internal quality control in our unit . But differing prognostic accuracy for various risk strata and subgroups as well as differences between the scores indicate that other factors than the overall quality of an ICU influence the results ."
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[] |
[] |
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IntensiveMedizin.80350699.eng.abstr
|
IntensiveMedizin.80350699.eng.abstr
|
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"text": [
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],
"offsets": [
[
0,
371
]
]
}
] |
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}
] |
[] |
[] |
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IntensiveMedizin.80350705.eng.abstr
|
IntensiveMedizin.80350705.eng.abstr
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"Thyrotoxicosis is not only able to aggravate preexisting cardiac disease but can also by itself lead to atrial fibrillation , cardiomegaly or congestive heart failure . In hyperthyreoidism , the total blood volume increases , the peripheral vascular resistence decreases , and cardiac failure may occur despite an increased cardiac output at rest . These changes can lead to \" high output failure \" . This case report deals with severe congestive heart failure , dilatation of the left ventricle , and tachyarrhythmia without preexisting heart disease in a patient with Graves disease . Complete reversion of symptoms were seen during treatment . The special implications of cardiavascular pharmacotherapy , especially the risk of early -blocker therapy in patients suffering from thyrotoxicosis with severe congestive heart failure are emphasized ."
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[] |
[] |
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] |
IntensiveMedizin.80350715.eng.abstr
|
IntensiveMedizin.80350715.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350715.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The mortality of acute renal failure ( ARF ) has remained unchanged in the last 10 to 20 years and is currently 50 - 70% . This is due to the fact that ARF today in nearly all cases is no single organ failure but part of a multiple organ failure ( MOF ) ."
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}
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[] |
[] |
[] |
IntensiveMedizin.80350724.eng.abstr
|
IntensiveMedizin.80350724.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350724.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This contribution summarizes a discussion of several experts on the field of clinical nutrition , which was held in Evangelische Akademie Loccum , Germany , May 20-21 , 1998. Nutrition can be considered a medical treatment , which justifies assessment of benefits according to outcome parameters . With regard to nutritional support of the cancer patient , evaluation of quality of life ( QL ) is more appropriate than morbidity and survival related parameters . Quality of life is a multidimensional construct which can be measured by standardized questionnaires . The QL Questionnaire ( QLQ-C30) of the European Organization for Research and Treatment of Cancer ( EORTC ) , is an established and validated instrument which provides reliable information with regard to disease-related limitations of QL . The measurement of QL can be extended by appropriate modules for specific problems according to the underlying cancer disease and special therapies ( e.g. , percutaneous endoscopic gastrostomy ) . In the individual case , the interpretation of the role of nutritional parameters for QL may be confounded by other parameters , such as disease or personal changes . However , the information supports decision making about the indication , the route of nutritional therapy , as well as individual follow-up . Using QL as an outcome parameter , carefully designed prospective trials might be feasible in order to investigate the outcome of nutritional therapy in patients with advanced cancer . The inclusion of a control group is questionable from the ethical viewpoint ."
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IntensiveMedizin.8035s003.eng.abstr
|
IntensiveMedizin.8035s003.eng.abstr
|
[
{
"id": "IntensiveMedizin.8035s003.eng.abstr-passage-0",
"type": "abstract",
"text": [
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],
"offsets": [
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0,
305
]
]
}
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[] |
[] |
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] |
IntensiveMedizin.8035s019.eng.abstr
|
IntensiveMedizin.8035s019.eng.abstr
|
[
{
"id": "IntensiveMedizin.8035s019.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Hemodynamic monitoring of the critically ill patient with pulmonary artery catheterization has been followed by controversy through the decades although most clinicians believe that the catheter is useful in diagnosis and treatment of a variety of clinical conditions . Its ability to measure important hemodynamic indices allows more accurate determination of the hemodynamic status of critically ill patients and , furthermore , a modification of treatment modalities ( e.g. , volume therapy , therapy with vasoactive substances ) . Moreover , evidence exists that right heart catheterization may fail to improve outcomes in some circumstances and maybe associated with an increased risk of death . The ultimate effectiveness of invasive hemodynamic monitoring in terms of outcome remains uncertain , for lack of properly designed clinical trials . Therefore , appropriate indications for pulmonary artery catheter monitoring according to recommendations of a recent consensus conference are mainly based upon expert opinions . Consistent with this expert panel and other medical societies a moratorium on the use of pulmonary artery catheters is not warranted . Randomized , controlled trials of pulmonary artery catheters should be conducted to further define the effectiveness of this type of intervention . Clinicians ' knowledge about the use of the pulmonary artery catheter and its complications as well as current training should be improved ."
],
"offsets": [
[
0,
1453
]
]
}
] |
[
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[
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52
]
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{
"id": "IntensiveMedizin.8035s019.eng.abstr-s1-t3",
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"artery"
],
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] |
[] |
[] |
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IntensiveMedizin.8035s036.eng.abstr
|
IntensiveMedizin.8035s036.eng.abstr
|
[
{
"id": "IntensiveMedizin.8035s036.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Recognizing the various complexities integral to CO2 elimination and oxygen availability establishes the need for invasive respiratory monitoring . Hypercapneic failure may be the result of several pathological factors , which include CO2 production , dead-space ratio , and total minute ventilation . The latter comprises interactive balances that include central respiratory drive , respiratory impedance , and respiratory muscle capacity . Invasive monitoring is currently available to assess each of these factors . However , some of them are primarily research tools ( e.g. , diaphragmatic electromyographic analyses , tensiontime index ) . At what level each is utilized will depend on the patient population , hospital economics , adequate nutritional plans , and a sound data base . Invasive respiratory monitoring in hypoxemic respiratory failure can lead to greater accuracy in diagnosis as well as in determining the patient's response to therapy . The level of priority depends on the patient's demands and the hospital economics . The approach to monitoring may also be based on the suspected pathophysiological etiology of hypoxemia and could include arterial , pulmonary capillary , and mixed-venous sampling , associated calculations ( e.g. , oxygen content ) , alveolar gas metering , estimation of shunt , mouth occlusion pressures , wedge pressure , stroke volume , expiratory hold , volume-time curves , and flow-time curves . Almost all standard ICUs have the capacity to determine these measurements . Most of the data are obtained as part of routine ICU management of the critically ill patient , and only few options are used by researchers ( e.g. , multiple inert gas elimination technique ) . In summary , monitoring both hypercapneic and hypoxemic respiratory failure invasively and accurately plays a crucial role in critical care ."
],
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[
0,
1860
]
]
}
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] |
IntensiveMedizin.8035s043.eng.abstr
|
IntensiveMedizin.8035s043.eng.abstr
|
[
{
"id": "IntensiveMedizin.8035s043.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The treatment of critically ill patients compromises frequently between an adequate fluid resuscitation for maintenance of a sufficient regional perfusion on the one hand and the avoidance of pulmonary edema on the other hand . The application of the transpulmonary indicator dilution method allows the orientation of fluid therapy by using the parameters ' intrathoracic blood volume ' and ' extravascular lung water ' . This technique is less invasive than the pulmonary artery catheter since it only needs a 3 or 4 French catheter in the femoral artery . Additionally , controlling the fluid therapy with the pulmonary capillary wedge pressure is severely limited in the mechanically ventilated patient . Therefore , the intrathoracic blood volume may be of advantage in the critically care patient in comparison to the pulmonary capillary wedge pressure to assess the cardiac preload . Furthermore , the indocyanine clearance adds a valuable parameter to assess liver function when the double indicator technique is used ."
],
"offsets": [
[
0,
1026
]
]
}
] |
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"id": "IntensiveMedizin.8035s043.eng.abstr-s1-t10",
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"id": "IntensiveMedizin.8035s043.eng.abstr-s2-t3",
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"id": "IntensiveMedizin.8035s043.eng.abstr-s2-t7",
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]
}
] |
[] |
[] |
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IntensiveMedizin.8035s048.eng.abstr
|
IntensiveMedizin.8035s048.eng.abstr
|
[
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],
"offsets": [
[
0,
373
]
]
}
] |
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349
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],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0026724"
}
]
}
] |
[] |
[] |
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IntensiveMedizin.8035s058.eng.abstr
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IntensiveMedizin.8035s058.eng.abstr
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"Brain electrical monitoring is sensitive to changes in neuronal function due to ischemic or traumatic neuronal injury . The sensitivity and specificity to detect these functional changes varies with the type of insult and the choice of the background anesthetic . Measurements of depth of anesthesia ( using arousal patterns of the EEG ) as well as specific EEG patterns for pharmacodynamic quantification of drug effects promise to achieve the optimum relation between anesthetic dose and anesthetic effect . Transcranial Doppler sonography is a semiquantitative , noninvasive and continuous measure of changes in cerebral blood flow ( CBF ) induced by anesthetics , narcotics or CBF autoregulation . Monitoring of the diastolic blood flow velocity pattern is a sensitive parameter of critical CBF and ischemic neuronal dysfunction due to decreases in cerebral perfusion pressure . Laser Doppler flowmetry is an invasive but continuous technique used to assess changes in microcirculatory CBF in the vicinity of brain lesions . While increases and decreases in CBF can be detected , thresholds indicating ischemia and hyperemia still have to be identified . Monitoring of jugular bulb venous oxygen saturation reflects the balance between cerebral oxygen supply and cerebral oxygen demand . This allows determination of the critical threshold level of cerebral perfusion pressure below which increasing oxygen extraction relates to cerebral hypoperfusion . Near infrared spectroscopy promises to be a technology with potential for noninvasive measurements of cerebral oxygen saturation , mitochondrial oxygen availability , and CBF . However , with the current technology , near infrared spectroscopy suffers from contamination of the signal from extracranial sources . Invasive brain tissue pO2 measurements accurately reflect local oxygenation of cerebral tissue and may help to taper the perioperative hemodynamic management according to the individual status of the patient ."
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[] |
[] |
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IntensiveMedizin.8035s065.eng.abstr
|
IntensiveMedizin.8035s065.eng.abstr
|
[
{
"id": "IntensiveMedizin.8035s065.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To prevent secondary cerebral hypoxia and ischemia in comatose patients , monitoring of cerebral blood flow and cerebral oxygenation is of great importance . Monitoring of the jugular venous oxygen saturation ( SjvO2) has been shown to continuously evaluate cerebral oxygenation and , thus , enabling the estimation of cerebral blood flow . A SjvO2 below 50% indicates a critically reduced cerebral oxygenation ."
],
"offsets": [
[
0,
412
]
]
}
] |
[
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[] |
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IntensiveMedizin.8035s080.eng.abstr
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IntensiveMedizin.8035s080.eng.abstr
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"Cerebral microdialysis is a potent research tool in experimental neurobiology and is now also introduced in intraoperative monitoring and neurointensive care . The method has the potential to be used as focal monitoring of intact brain or of brain regions of therapeutic interest . Our work includes experimental assessment of sensitive parameters as glucose , lactate , glucose-lactate index , and pH of dialysates . The investigation included focal cerebral ischemia , intracerebral and subdural haematoma , and glutamate neurotoxicity . The clinical work used intraoperative monitoring to assess normal value ranges , pathophysiologic ranges , and neurochemical monitoring in neurointensive patients . Our experience shows that some neurochemical cases monitored with microdialysis show early changes , in three cases even anticipating clinical worsening . We conclude that cerebral microdialysis has a future in our field ."
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[] |
[] |
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IntensiveMedizin.8035s088.eng.abstr
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IntensiveMedizin.8035s088.eng.abstr
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[] |
[] |
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] |
IntensiveMedizin.8035s092.eng.abstr
|
IntensiveMedizin.8035s092.eng.abstr
|
[
{
"id": "IntensiveMedizin.8035s092.eng.abstr-passage-0",
"type": "abstract",
"text": [
"As a result of theoretical considerations , experimental results , and clinical experiences concerning an optimal or critical hemoglobin concentration of a patient in the intensive care unit , an optimal value of 10 +/- 2 g/dl is derived , which as a result of hemodilution of any cause needs no correction by hemotherapy . A transfusion of erythrocytes in the hemoglobin concentration range of 7 to 10 g/dl is accepted only when reasons are given , i.e. , transfusion is only accepted for a patient with signs of general or local hypoxia . These data are valid for a patient under normoxia , normovolemia , and normothermia ."
],
"offsets": [
[
0,
626
]
]
}
] |
[
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"hemoglobin"
],
"offsets": [
[
126,
136
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019046"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"concentration"
],
"offsets": [
[
137,
150
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0086045"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"patient"
],
"offsets": [
[
156,
163
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"care"
],
"offsets": [
[
181,
185
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0150499"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"value"
],
"offsets": [
[
204,
209
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042295"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"hemodilution"
],
"offsets": [
[
261,
273
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019009"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"cause"
],
"offsets": [
[
281,
286
]
],
"normalized": [
{
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"db_id": "C0015127"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"hemotherapy"
],
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[
310,
321
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0087111"
},
{
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"db_id": "C0039798"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"hemoglobin concentration"
],
"offsets": [
[
126,
150
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019029"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t10",
"type": "umlsterm",
"text": [
"intensive care"
],
"offsets": [
[
171,
185
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0085559"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s1-t11",
"type": "umlsterm",
"text": [
"intensive care unit"
],
"offsets": [
[
171,
190
]
],
"normalized": [
{
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"db_id": "C0021708"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"erythrocytes"
],
"offsets": [
[
341,
353
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0014792"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"hemoglobin"
],
"offsets": [
[
361,
371
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019046"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"concentration"
],
"offsets": [
[
372,
385
]
],
"normalized": [
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"db_id": "C0086045"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"patient"
],
"offsets": [
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492,
499
]
],
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{
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"db_id": "C0030705"
}
]
},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"signs"
],
"offsets": [
[
505,
510
]
],
"normalized": [
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"db_id": "C0220912"
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},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"hypoxia"
],
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531,
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],
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},
{
"id": "IntensiveMedizin.8035s092.eng.abstr-s2-t7",
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],
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{
"id": "IntensiveMedizin.8035s092.eng.abstr-s3-t1",
"type": "umlsterm",
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"patient"
],
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[
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]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
}
] |
[] |
[] |
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{
"id": "IntensiveMedizin.8035s092.eng.abstr-s2-r7-t7.1-t5.1",
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}
] |
IntensiveMedizin.8035s102.eng.abstr
|
IntensiveMedizin.8035s102.eng.abstr
|
[
{
"id": "IntensiveMedizin.8035s102.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Although the risks and side effects of blood transfusions have been significantly reduced during the past years , the potential infectious and immunologic side effects still require a clear and restricted indication before each transfusion is performed . However , the transfusion errors before and during administration of blood components nowadays represent the highest risk in particular for critical care and high risk patients . This article focuses on the specific problems of handling , preparation , and practical performance of transfusions . Some practical aspects and problems of transfusions are examplary shown for intensive care and high risk patients , such as immunosuppressed , transplanted or polytraumatic patients and critical care premature neonates ."
],
"offsets": [
[
0,
772
]
]
}
] |
[
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13,
18
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"blood"
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{
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154
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{
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"type": "umlsterm",
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"blood transfusions"
],
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"side effects"
],
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155,
167
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{
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"administration"
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}
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},
{
"id": "IntensiveMedizin.8035s102.eng.abstr-s2-t3",
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"risk"
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376
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{
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]
},
{
"id": "IntensiveMedizin.8035s102.eng.abstr-s2-t4",
"type": "umlsterm",
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"care"
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{
"id": "IntensiveMedizin.8035s102.eng.abstr-s2-t5",
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"id": "IntensiveMedizin.8035s102.eng.abstr-s2-t6",
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"patients"
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{
"id": "IntensiveMedizin.8035s102.eng.abstr-s2-t7",
"type": "umlsterm",
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"blood components"
],
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340
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"id": "IntensiveMedizin.8035s102.eng.abstr-s2-t8",
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"critical care"
],
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395,
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642
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},
{
"id": "IntensiveMedizin.8035s102.eng.abstr-s4-t2",
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"id": "IntensiveMedizin.8035s102.eng.abstr-s4-t3",
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"id": "IntensiveMedizin.8035s102.eng.abstr-s4-t5",
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"care"
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"id": "IntensiveMedizin.8035s102.eng.abstr-s4-t6",
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{
"id": "IntensiveMedizin.8035s102.eng.abstr-s4-t7",
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{
"id": "IntensiveMedizin.8035s102.eng.abstr-s4-t8",
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"critical care"
],
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751
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"normalized": [
{
"db_name": "UMLS",
"db_id": "C0010337"
}
]
}
] |
[] |
[] |
[
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{
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{
"id": "IntensiveMedizin.8035s102.eng.abstr-s1-r8-t2.2-t3.1",
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},
{
"id": "IntensiveMedizin.8035s102.eng.abstr-s1-r9-t3.1-t2.1",
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{
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{
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{
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{
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{
"id": "IntensiveMedizin.8035s102.eng.abstr-s1-r14-t3.1-t4.1",
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{
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{
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},
{
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},
{
"id": "IntensiveMedizin.8035s102.eng.abstr-s1-r20-t6.1-t4.1",
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},
{
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] |
IntensiveMedizin.8035s109.eng.abstr
|
IntensiveMedizin.8035s109.eng.abstr
|
[
{
"id": "IntensiveMedizin.8035s109.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Liver function is closely related to hemostasis due to the fact that almost all components participating in clotting and fibrinolysis are synthesized in liver parenchymal cells and the liver's reticuloendothelial cell system participates in the regulation of hemostasis . Advanced liver function defects result in signs of decreased synthesis of hemostasis-related proteins and increased turnover of coagulation and fibrinolysis . A labile balance in hemostasis usually results without any requirement to correct clinically asymptomatic laboratory abnormalities . Clinically the decompensation of hemostasis in liver diseases due to different noxious agents results more often in bleeding with more or less pronounced laboratory signs of disseminated intravascular coagulation , consumption coagulopathy or hyperfibrinolysis and only rarely in overt thromboembolism ."
],
"offsets": [
[
0,
867
]
]
}
] |
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IntensiveMedizin.90360005.eng.abstr
|
IntensiveMedizin.90360005.eng.abstr
|
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],
"offsets": [
[
0,
509
]
]
}
] |
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}
] |
[] |
[] |
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] |
IntensiveMedizin.90360015.eng.abstr
|
IntensiveMedizin.90360015.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360015.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Urinary tract infections are the most frequent nosocomial infections , accounting for about 40% of all nosocomial infections . In most cases these infections are associated with indwelling urinary catheters . The guideline from the Centers for Disease Control and Prevention ( Atlanta , USA ) for the prevention of catheter-associated urinary tract infections , as the most important evidence-based guideline worldwide , was published in 1981 and has not been updated so far . Evidence-based national guidelines are not available in Germany . We have , therefore , performed a literature search for randomized , controlled studies on the prevention of catheter-associated urinary tract infections ( Medline , Cochrane Library , reference text books ) published since 1981. Fifty studies meeting our inclusion criteria were identified . Substantial new findings have been published on alternatives to urethral catheters and new catheter materials . Based upon the CDC guideline , whose principles are still valid , updated guidelines for the prevention of catheter-associated urinary tract infections have been developed by the National Reference Center for Hospital Hygiene ."
],
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0,
1175
]
]
}
] |
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}
] |
[] |
[] |
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] |
IntensiveMedizin.90360027.eng.abstr
|
IntensiveMedizin.90360027.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360027.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Currently , coronary bypass operation for acute myocardial ischemia is restricted to patients with recent coronary occlusion resulting from failed PTCA and to patients with mechanical complications of myocardial infarction . The majority of patients suffering acute myocardial infarction are treated with thrombolytic therapy or PTCA . Revascularization using PTCA or thrombolysis is followed by reperfusion with normal blood at systemic pressure . Despite restoration of perfusion within 6-8 h , this reperfusion modality is associated with reperfusion injury and failure to return segmental contractility . In contrast , coronary artery bypass operation using extracorporeal circulation provides complete unloading of the myocardium and controlled conditions of initial reperfusion as well as of the reperfusate composition . This technique attenuates reperfusion injury and enables early return of segmental contractility in the ischemic area . In the future , surgical revascularization could gain increasing importance as a therapeutic option in the setting of acute myocardial infarction . Prospective , randomized trials comparing thrombolysis , PTCA , and bypass operation are recommended ."
],
"offsets": [
[
0,
1198
]
]
}
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] |
IntensiveMedizin.90360033.eng.abstr
|
IntensiveMedizin.90360033.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360033.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The onset of sepsis often represents a life-threatening complication in an intensive care setting . Early diagnosis is crucial to the further course of the disorder and the prognosis for the patient . Scoring systems for early diagnosis of postoperative and wound sepsis have already been developed for groups of surgical patients . However , these systems cannot by applied without restriction to groups of nonsurgical patients . The purpose of this study was to develop an easily implemented scoring system for confirming the diagnosis and monitoring the course of sepsis in a group of nonsurgical intensive care patients without having to resort to invasive catheterization to measure cardiac output . A sepsis score was developed with seven individual parameters : respiration rate , heart rate , body temperature , C-reactive protein , lactate , leukocytes , and thrombocytes . The highest point value of each individual parameter is 3 ; the score for a maximum septic circulatory situation is 21."
],
"offsets": [
[
0,
1002
]
]
}
] |
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IntensiveMedizin.90360046.eng.abstr
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IntensiveMedizin.90360046.eng.abstr
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"We report a case of a 26-year-old patient , a tilelayer by profession , with a history of a fall from a height of 5 meters with blunt thoracic injury and resultant left atrial rupture . The emergency doctor found at the site of accident a deeply comatose patient ( Glasgow Coma Scale 3 points ) with no recordable blood pressure . After two hours of resuscitation at the site of accident and at the closest emergency traumatology unit a marginal blood pressure was seen . With a suspicion of a closed ascending aortic rupture the patient was transferred to the nearest cardiothoracic surgical unit . During transfer , the patient had a cardiac standstill with asystole and was further reanimated and resuscitated . On arrival the patient was transferred to the operation theatre immediately and after femoro-femoral cannulation was supported by a heart-lung-machine circulation . Through an optimal exposition the internal thoracic organs were inspected in detail and the rupture of the left atrium was identified and treated . The heart was effectively emptied and with deep hypothermia with a reduction of oxygen consumption by all organs especially the brain was taken care of . The patient could be discharged from hospital on the 18th postoperative day in absolute good health ."
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[] |
[] |
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] |
IntensiveMedizin.90360051.eng.abstr
|
IntensiveMedizin.90360051.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360051.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The authors report on a 28 year old female with severe thrombotic thrombocytopenic purpura TTP , Morbus Moschcowitz . Initially , it was possible to overcome critical phases with a combination of plasmapheresis , corticosteroids , and Vinca-alcaloids . Later , the patient was stabilized on plasmapheresis alone . Relapses occured after stretching the intervals between the plasmapheresis to more than 4 d . After the 64th plasmapheresis we applied 0.350 mg/kg body weight daily immunglobuline i.v. over 5 d . Thereafter the patient did well over 6 months without relapsing . The current literature according the use of IVIG in TTP is discussed ."
],
"offsets": [
[
0,
646
]
]
}
] |
[
{
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35
]
],
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}
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},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"female"
],
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[
36,
42
]
],
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{
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}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"purpura"
],
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[
83,
90
]
],
"normalized": [
{
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"db_id": "C0034150"
}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s1-t4",
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"text": [
"TTP"
],
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91,
94
]
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]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s1-t5",
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"thrombocytopenic purpura"
],
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66,
90
]
],
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"db_id": "C0034153"
}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"thrombotic thrombocytopenic purpura"
],
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55,
90
]
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"normalized": [
{
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}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"plasmapheresis"
],
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196,
210
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],
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"db_id": "C0032134"
}
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},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"corticosteroids"
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228
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],
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"db_id": "C0001617"
}
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},
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"id": "IntensiveMedizin.90360051.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"patient"
],
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265,
272
]
],
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{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"plasmapheresis"
],
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[
291,
305
]
],
"normalized": [
{
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"db_id": "C0032134"
}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"Relapses"
],
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314,
322
]
],
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"db_id": "C0035020"
}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"plasmapheresis"
],
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[
374,
388
]
],
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"db_id": "C0032134"
}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
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],
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423,
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],
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}
]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"weight"
],
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472
]
],
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"db_id": "C0005910"
},
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"db_name": "UMLS",
"db_id": "C0043100"
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]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"body weight"
],
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461,
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"normalized": [
{
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},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s6-t1",
"type": "umlsterm",
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],
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525,
532
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},
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"id": "IntensiveMedizin.90360051.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"literature"
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588,
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{
"id": "IntensiveMedizin.90360051.eng.abstr-s7-t2",
"type": "umlsterm",
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},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s7-t3",
"type": "umlsterm",
"text": [
"IVIG"
],
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620,
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],
"normalized": [
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]
},
{
"id": "IntensiveMedizin.90360051.eng.abstr-s7-t4",
"type": "umlsterm",
"text": [
"TTP"
],
"offsets": [
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631
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],
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"db_id": "C0076582"
},
{
"db_name": "UMLS",
"db_id": "C0034155"
}
]
}
] |
[] |
[] |
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IntensiveMedizin.90360104.eng.abstr
|
IntensiveMedizin.90360104.eng.abstr
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[] |
[] |
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IntensiveMedizin.90360126.eng.abstr
|
IntensiveMedizin.90360126.eng.abstr
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[
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"id": "IntensiveMedizin.90360126.eng.abstr-passage-0",
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] |
IntensiveMedizin.90360138.eng.abstr
|
IntensiveMedizin.90360138.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360138.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Deep venous thrombosis is a common disease affecting 1-3 of 1000 adults per year . The goals of therapy are preventing pulmonary embolism and thrombus growth , restoring venous outflow tract to avoid postthrombotic syndrome and reducing acute pain . For the first two goals a fast and effective anticoagulation is mandatory , which was mainly achieved with intravenous administration of unfractionated heparin therefore requiring control of aPTT and adjustment of the dosis . The low molecular weight heparins allow an effective anticoagulation by body weight adjusted subcutaneous application . There is some evidence that low molecular weight heparins are superior to unfractionated heparins with regard to thrombus extension , hemorrhages and mortality . The first studies for the treatment of deep venous thrombosis at home are discussed . The long term treatment of venous thromboembolism is performed with oral anticoagulants . The therapeutic range is an INR of 2.0 to 3.0. The duration of oral anticoagulation varies according to etiology , clinical course and risk of recurrence . Thrombolysis or thrombectomy has not been shown to be superior to conservative treatment in long term follow up and should be considered in selected cases ."
],
"offsets": [
[
0,
1246
]
]
}
] |
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] |
[] |
[] |
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IntensiveMedizin.90360145.eng.abstr
|
IntensiveMedizin.90360145.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360145.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Despite advancing knowledge of the pathophysiology and treatment of asthma , asthma mortality is not reduced . Patients with severe asthma exacerbations develop progressive airflow obstruction over hours to days as a result of airway wall inflammation , bronchospasm and intraluminal mucus . Airflow obstruction causes ventilation-perfusion inequality , lung hyperinflation , and increased work of breathing . Severe cases are characterized by an inability to speak , diaphoresis , pulsus paradoxus , accessory muscle use , low peak expiratory flow rate , and a rising partial pressure of carbon dioxide . Inhaled beta-agonists , theophylline , systemic corticosteroids , and oxygen remain the drugs of choice in severe asthma exacerbations . Anticholinergics play a lesser role in the treatment of acute asthma . Available data do not support the routine use of ketamine , magnesium sulfate , heliox or antibiotics in patients with severe asthma exacerbations . For now , bronchoscopy with BAL should not be considered a part of the routine management of asthmatics . Patients failing drug therapy should be considered early for noninvasive ventilation or intubation and mechanical ventilation . Noninvasive positive pressure ventilation are promising adjuncts to the treatment of nonintubated patients . A strategy of mechanical ventilation including limition of minute ventilation , decreasing inspiratory peak pressure , and tolerating hypercapnia , avoids excessive lung hyperinflation and barotrauma . Indirect evidence suggests that this approach to mechanical ventilation in acute severe asthma decreases morbidity and mortality ; however , the key to the management of this disease ( which in many cases represents a failure of outpatient management ) is patient education and disease prevention ."
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] |
[] |
[] |
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IntensiveMedizin.90360156.eng.abstr
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IntensiveMedizin.90360156.eng.abstr
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[] |
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IntensiveMedizin.90360163.eng.abstr
|
IntensiveMedizin.90360163.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360163.eng.abstr-passage-0",
"type": "abstract",
"text": [
"During spontaneous breathing , the respiratory muscle pressure ( Pmus ) waveform is determined by a complex system consisting of a motor arm , a control center , and various feedback mechanisms that convey information to the control center . During assisted mechanical ventilation , the pressure delivered by the ventilator ( Paw ) is incorporated into the system and may alter the Pmus waveform , which in turn modifies the function of the ventilator . Thus , the response of Pmus to Paw and the response of Paw to Pmus constitute the two components of patient-ventilator interaction as well as of control of breathing during assisted mechanical ventilation . The response of Paw to Pmus depends on : 1 ) the mode of ventilatory support ; 2 ) the mechanics of the respiratory system , and 3 ) the characteristics of the Pmus waveform . On the other hand the response of Pmus to Paw is mediated through four feedback systems : 1 ) mechanical ; 2 ) chemical ; 3 ) reflex , and 4 ) behavioral . It follows that the system that controls the act of breathing may be considerably modified by mechanical ventilation . The physician dealing with a mechanically ventilated patient should take into account the interaction between the respiratory effort and the function of the ventilator and be aware that the ventilatory output may or may not reflect the various aspects of control of breathing ."
],
"offsets": [
[
0,
1389
]
]
}
] |
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[] |
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IntensiveMedizin.90360174.eng.abstr
|
IntensiveMedizin.90360174.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360174.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The occurrence of intermittent nocturnal bradycardia as well as bradyarrhythmias should lead to diagnosis of confounding sleep related breathing disorders ( SRBD ) . From a therapeutic and prognostic point of view , a diagnosis with complete history , noninvasive and , if necessary , invasively cardiological investigations as well as cardiorespiratory polysomnography is essential . Apart from the exclusion or confirmation of a SRBD as the cause for nocturnal bradyarrhythmias , polysomnography enables the diagnosis of bradyarrhythmias which only occur during REM sleep . Bradyarrhythmias can usually be removed by effective therapy of the SRBD by nasal ventilation . It is still being discussed if patients with apnea-associated bradyarrhythmias require the implantation of a permanent pacemaker ."
],
"offsets": [
[
0,
802
]
]
}
] |
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IntensiveMedizin.90360190.eng.abstr
|
IntensiveMedizin.90360190.eng.abstr
|
[
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"With a postal survey we investigated the situation of intensive care medicine in hospitals where pneumologists organized in the German Society of Pneumology ( DGP ) are employed . Of more than 1600 interviewed 240 responded , representing 145 different hospitals ( overall response rate 14.4% ) . All members of the DGP were questionaired about the type of hospital , the organization , and size of the department of respiratory medicine ( independent , semi-independent , or not independent at all ) as well as the organization and size of the intensive care units at their respective hospitals . In addition to this the technical resources available were investigated . Even though the fractions of intensive care beds of the total number of respiratory care beds are equal in university hospitals and specialized pulmonary care centers the part of intensive care units that are headed by pneumologists are inadequately low in university ( 8% ) as well as general type hospitals ( 2% ) and even in specialized respiratory care centers ( 45% ) only part of the ICUs are run by pneumologists . In Germany - in contrast to other countries - the existing deficit of respiratory care medicine at university hospitals is reflected in an even aggravated fashion in the lack of involvement in intensive care medicine ."
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IntensiveMedizin.90360203.eng.abstr
|
IntensiveMedizin.90360203.eng.abstr
|
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"Objective : To evaluate the performance of the Simplified Acute Physiology Score ( SAPS II ) in critical ill patients of a medical ICU with bronchial and pulmonary diseases . Background : Evaluations of the prognostic power of SAPS II in groups of patients with homogeneous etiologies of critical illness came to quite different results . The predictive power of a score system must be reevaluated before reliable conclusions can be drawn in given groups of patients . Methods : SAPS II score , risk of death , outcome of hospital treatment ( died , survived ) , age , length of stay in the ICU and in the hospital , underlying disease were recorded in all 262 critically ill patients with bronchial or pulmonary diseases out of a total group of 3797 intensive care patients treated in the medical ICU of a community teaching hospital ( 1995-1998 ) . Patients treated with artificial ventilation were considered as a subgroup . ROC curves and area under curve ( AUC ) were calculated to evaluate discrimination power . A formal goodness-of-fit test was performed , and a calibration curve calculated to evaluate calibration . Results : In 262 critically ill patients with bronchopulmonary diseases , mean age was 60.4 +/- 17.9 y , SAPS II 34.9 +/- 20.2 , median risk of death 0.09 ( 25% ; 75% percentile 0.03 ; 0.42 ) , mortality in the ICU 9.9% , hospital mortality 17.2% , standardized mortality index 0.68 ( 0.57-0.83; 95% convidence interval ) . The AUC was 0.83 +/- 0.03. Chi2 was 40.16 and the p value 0.001 for the goodness-of-fit test . The calibration curve demonstrated significant overestimation of predicted hospital death in patients with a risk of death > 0.4. Conclusion : SAPS II had a strong discrimination poor , but a poor calibration performance in critically ill patients of the bronchopulmonary disease category . For investigations requiring a very accurate prediction of hospital outcome across all classes of mortality risk , the score must be adjusted to the group of patients under investigation ."
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IntensiveMedizin.90360209.eng.abstr
|
IntensiveMedizin.90360209.eng.abstr
|
[
{
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"A difficult airway can render mask ventilation or laryngoscopic intubation difficult or impossible . A simple physical examination can often identify the difficult airway in advance . In these cases , the knowledge of alternative methods of airway management can be lifesaving for the patient . Further , such scenarios have significant forensic implications for the physician . Fiberoptic intubation is often optimal in those situations that allow for sufficient time and the presence of the necessary equipment and a trained physician and ancillary staff . Alternative techniques such as the laryngeal mask airway ( LMA ) and the combitube or the use of stylets and the gum elastic bougie can be employed successfully in selected patients by experienced personnel . Algorithms can promote problem awareness and devise logical steps for successfully airway management . Although surgical airway management by cricoidotomy or tracheotomy is associated with more frequent complications , it is indispensable in critical situations . Since patient safety is the foremost goal , ethical obligations demand that every physicians be familiar with techniques that ensure adequate management of a difficult airway ."
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1208
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}
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[] |
[] |
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IntensiveMedizin.90360220.eng.abstr
|
IntensiveMedizin.90360220.eng.abstr
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"Assisted mode of ventilation is often more comfortable for the patient as compared to controlled ventilation not only during weaning but also during the acute phase of ventilation . Aim of mechanical ventilation in assisted mode is to get optimal synchronisation between ventilator and patient and reduction of work of breathing . To optimize assisted mode of ventilation new techniques were developed to reduce or compensate the resistance of the tube ( automatic tube compensation ( ATC ) ) . Proportional assist ventilation ( PAV ) allows not only to reduce resistive components of work of breathing but also to reduce elastic properties of airway mechanics of the intubated patient ."
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IntensiveMedizin.90360224.eng.abstr
|
IntensiveMedizin.90360224.eng.abstr
|
[
{
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"Approaches for the diagnosis of ventilator-associated pneumonia have two goals , namely to determine the presence of pneumonia as well as its causative pathogens . Traditional diagnostic measures such as clinical and radiographic criteria and qualitative cultures of tracheobronchial aspirates ( TBAS ) are associated with considerable limitations as regards sensitivity and particularly specificity . Therefore , patients are at risk to be \" overtreated \" with antibiotics . On the other hand , prolonged antibiotic treatment represents an important risk factor for pneumonia . The specificity of isolates in culture can be significantly improved by applying the quantitative culture technique . Bronchoscopic techniques to retrieve respiratory secretions ( PSB , BAL with quantitative culture ) have only marginally increased specificity as compared to quantitative cultures of TBAS . Morbidity and Mortality are not influenced by the techniques used for microbial investigation . Therefore , TBAS is useful as primary diagnostic measure . Bronchoscopic techniques may be applied individually and , therefore , should be established and available as well ."
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[] |
[] |
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] |
IntensiveMedizin.90360243.eng.abstr
|
IntensiveMedizin.90360243.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360243.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Hemoglobin solutions and fluorocarbon emulsions are evaluated as artificial oxygen carriers . The efficacy of hemoglobin solutions with respect to O2 transport and especially the effective O2 release to tissues has been demonstrated in a number of situations , such as extreme hemodilution and hemorrhagic shock . The hemoglobin molecule could be stabilized by genetic and chemical modifications . This results in a clinically utilizable intravascular half-life of about 8-24 h , an adequate O2 affinity , and a lack of nephrotoxicity . A degree of vasoconstriction must be mentioned as the persistent side effect of the hemoglobin solutions evaluated here . In spite of this , hemoglobin solutions are also well tolerated in humans . Fluorocarbon emulsions are compounds with a very high gas solubility and are , therefore , well suited for the transport of O2 and CO2. The capacity for the release of O2 to the tissues is especially excellent . This was demonstrated under extreme hemodilution , during extracorporeal circulation and also under reanimation . Perflubron , the most important representative of the fluorocarbon emulsions , has also been successfully used in man and is well tolerated . The introduction of artificial oxygen carriers to clinical practice will greatly change transfusion medicine and also the acute care of trauma patients . Launch is expected within the next few years ."
],
"offsets": [
[
0,
1403
]
]
}
] |
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"id": "IntensiveMedizin.90360243.eng.abstr-s1-t7",
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"id": "IntensiveMedizin.90360243.eng.abstr-s2-t1",
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"hemoglobin"
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"id": "IntensiveMedizin.90360243.eng.abstr-s2-t3",
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"transport"
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"id": "IntensiveMedizin.90360243.eng.abstr-s2-t7",
"type": "umlsterm",
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"shock"
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"id": "IntensiveMedizin.90360243.eng.abstr-s2-t8",
"type": "umlsterm",
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"id": "IntensiveMedizin.90360243.eng.abstr-s3-t1",
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"id": "IntensiveMedizin.90360243.eng.abstr-s4-t1",
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"id": "IntensiveMedizin.90360243.eng.abstr-s5-t2",
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"id": "IntensiveMedizin.90360243.eng.abstr-s5-t4",
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"id": "IntensiveMedizin.90360243.eng.abstr-s6-t3",
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"id": "IntensiveMedizin.90360243.eng.abstr-s7-t5",
"type": "umlsterm",
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"type": "umlsterm",
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"id": "IntensiveMedizin.90360243.eng.abstr-s7-t7",
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"id": "IntensiveMedizin.90360243.eng.abstr-s7-t8",
"type": "umlsterm",
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757
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"id": "IntensiveMedizin.90360243.eng.abstr-s8-t1",
"type": "umlsterm",
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995
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]
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{
"id": "IntensiveMedizin.90360243.eng.abstr-s8-t2",
"type": "umlsterm",
"text": [
"circulation"
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1020,
1031
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"db_id": "C0005775"
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},
{
"id": "IntensiveMedizin.90360243.eng.abstr-s8-t3",
"type": "umlsterm",
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"db_id": "C0015354"
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},
{
"id": "IntensiveMedizin.90360243.eng.abstr-s9-t1",
"type": "umlsterm",
"text": [
"Perflubron"
],
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[
1061,
1071
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],
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"db_id": "C0162922"
}
]
},
{
"id": "IntensiveMedizin.90360243.eng.abstr-s9-t2",
"type": "umlsterm",
"text": [
"fluorocarbon"
],
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1115,
1127
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"db_id": "C0016340"
}
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{
"id": "IntensiveMedizin.90360243.eng.abstr-s9-t3",
"type": "umlsterm",
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{
"id": "IntensiveMedizin.90360243.eng.abstr-s9-t4",
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]
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{
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"id": "IntensiveMedizin.90360243.eng.abstr-s10-t1",
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"trauma"
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1345
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"db_id": "C0021501"
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{
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{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
}
] |
[] |
[] |
[
{
"id": "IntensiveMedizin.90360243.eng.abstr-s1-r1-t3.1-t4.1",
"type": "interacts_with",
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{
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{
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{
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},
{
"id": "IntensiveMedizin.90360243.eng.abstr-s1-r7-t5.2-t6.1",
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{
"id": "IntensiveMedizin.90360243.eng.abstr-s1-r8-t6.1-t5.2",
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IntensiveMedizin.90360250.eng.abstr
|
IntensiveMedizin.90360250.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360250.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Regional perfusion of the lung is not distributed homogeneously within the organ . This phenomenon has been explained by the classical concept of West et al. based on the isolated canine lung . The concept stresses the importance of different gravitational forces along the vertical axis of the lung resulting in three zones in which no pulmonary perfusion ( zone 1 ) , waterfall-like perfusion ( zone 2 ) , and continuous blood flow ( zone 3 ) prevail . In this article , we review recent publications in which observations have been made which cannot be explained by the West model . A new concept of distribution of regional pulmonary perfusion is presented which centers on vascular factors which are better suited to account for observed blood flow heterogeneities . The pulmonary vasculature is composed of repetitions of one structural unit : the vessel bifurcation . Apart from its size , each single bifurcation is similar to all others . The pulmonary vessel tree can , therefore , be considered to be self-similar . Self-similarity has been identified as a design principle of living nature . Self-similar objects can produce heterogeneity which is also self-similar when viewed at different scales of magnification . For measurement of the structure of such objects and their function , i.e. , in this case the heterogeneity of pulmonary perfusion , fractal geometry is best suited . Distribution of blood flow within the lung can be described by means of fractal analysis , and all phenomena of perfusion distribution can easily be explained when applying this concept . Furthermore , since the basis of fractal analysis is pulmonary vascular anatomy , it lends itself for the study of blood flow distribution . A major advantage is the independence of fractal parameters from resolution of perfusion measurements . Thus , fractal analysis can be used to compare results that have been obtained using different resolutions and different species . Fractal methods have previously been used in medicine for other purposes . Nonlinear analyses of heart beat variability can predict the onset of malign cardiac dysrhythmias hours before actual appearance in the ECG . Very similar methods applied to electrical brain activity have been shown to allow prediction of epileptical seizures approximately 15 min prior to appearance of clinical symptoms ."
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IntensiveMedizin.90360260.eng.abstr
|
IntensiveMedizin.90360260.eng.abstr
|
[
{
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"type": "abstract",
"text": [
"Reperfusion injury has become a scientific problem of increasing importance , in part because of recent developments of thrombolytic therapy . The mechanisms of reperfusion injury following focal cerebral ischemia , however , are not known in detail . Recent studies strongly suggest that reactive oxygen species ( ROS ) and calcium overload play an important role in reperfusion injury and that pharmacological interventions against calcium- or free radical-mediated damage could extend the therapeutic window in cerebral ischemia/reperfusion . The mediators involved are known to induce a mitochondrial permeability transition ( PT ) during the reperfusion period , which is associated with uncoupling of mitochondrial respiration , loss of mitochondrial membrane potential , and a burst production of ROS , leading to cellular death . The mitochondrial PT is considered to be a key process in reperfusion injury following cerebral ischemia , as also observed in other organs such as heart and liver . Pharmacological modulation of mitochondrial permeability changes have the potential to reduce tissue damage due to reperfusion ."
],
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0,
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}
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IntensiveMedizin.90360270.eng.abstr
|
IntensiveMedizin.90360270.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360270.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In pneumonia the initiation , maintenance , and resolution of inflammation is dependent upon the complex network of pro-inflammatory and anti-inflammatory cytokines . Much of our knowledge of the role of cytokines in the pathogenesis of pneumonia is derived from animal studies on experimental pneumonia . In contrast to systemic infection , where excessive production of pro-inflammatory cytokines is detrimental , causing organ failure and death , local production of pro-inflammatory cytokines is necessary for host defense against the invasive pathogen . Conversely , the anti-inflammatory cytokine IL-10 impairs host defense in local infections like pneumonia , while it protects against excessive immune activation , like sepsis . Studies on the role of cytokines in pneumonia in humans and animals are discussed in detail ."
],
"offsets": [
[
0,
830
]
]
}
] |
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[] |
[] |
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"id": "IntensiveMedizin.90360270.eng.abstr-s5-r3-t5.1-t4.1",
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"id": "IntensiveMedizin.90360270.eng.abstr-s5-r4-t4.1-t1.1",
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"normalized": []
},
{
"id": "IntensiveMedizin.90360270.eng.abstr-s5-r6-t4.1-t5.1",
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"arg2_id": "IntensiveMedizin.90360270.eng.abstr-s5-t5",
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},
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"id": "IntensiveMedizin.90360270.eng.abstr-s5-r12-t1.1-t4.1",
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"id": "IntensiveMedizin.90360270.eng.abstr-s5-r13-t5.1-t1.1",
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"normalized": []
}
] |
IntensiveMedizin.90360293.eng.abstr
|
IntensiveMedizin.90360293.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360293.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Paradoxical embolism is well-known in theory but rarely encountered in clinical practice . The typical pathophysiological background is the coincidence of venous thrombosis , elevated right atrial pressure , and a consecutive right-to-left shunting via a patent foramen ovale or an atrial septal defect ."
],
"offsets": [
[
0,
304
]
]
}
] |
[
{
"id": "IntensiveMedizin.90360293.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"embolism"
],
"offsets": [
[
12,
20
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013922"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"Paradoxical embolism"
],
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[
0,
20
]
],
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{
"db_name": "UMLS",
"db_id": "C0238096"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"thrombosis"
],
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[
162,
172
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040053"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"pressure"
],
"offsets": [
[
197,
205
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033095"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"patent"
],
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[
255,
261
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030650"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"defect"
],
"offsets": [
[
296,
302
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0243067"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"venous thrombosis"
],
"offsets": [
[
155,
172
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042487"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"foramen ovale"
],
"offsets": [
[
262,
275
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0016521"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
"septal defect"
],
"offsets": [
[
289,
302
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018816"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t8",
"type": "umlsterm",
"text": [
"patent foramen ovale"
],
"offsets": [
[
255,
275
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0016522"
}
]
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-t9",
"type": "umlsterm",
"text": [
"atrial septal defect"
],
"offsets": [
[
282,
302
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018817"
}
]
}
] |
[] |
[] |
[
{
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"type": "result_of",
"arg1_id": "IntensiveMedizin.90360293.eng.abstr-s2-t2",
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"id": "IntensiveMedizin.90360293.eng.abstr-s2-r3-t6.1-t1.1",
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"id": "IntensiveMedizin.90360293.eng.abstr-s2-r5-t1.1-t8.1",
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{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r6-t8.1-t4.1",
"type": "degree_of",
"arg1_id": "IntensiveMedizin.90360293.eng.abstr-s2-t8",
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},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r7-t4.1-t8.1",
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},
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},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r9-t8.1-t1.1",
"type": "associated_with",
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},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r10-t6.1-t4.1",
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},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r11-t8.1-t6.1",
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},
{
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"normalized": []
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r13-t4.1-t8.1",
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},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r14-t1.1-t6.1",
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},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r15-t6.1-t1.1",
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"arg2_id": "IntensiveMedizin.90360293.eng.abstr-s2-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r16-t6.1-t8.1",
"type": "result_of",
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"arg2_id": "IntensiveMedizin.90360293.eng.abstr-s2-t8",
"normalized": []
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r17-t1.1-t6.1",
"type": "associated_with",
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"normalized": []
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r18-t6.1-t8.1",
"type": "location_of",
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"arg2_id": "IntensiveMedizin.90360293.eng.abstr-s2-t8",
"normalized": []
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r19-t6.1-t1.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.90360293.eng.abstr-s2-t6",
"arg2_id": "IntensiveMedizin.90360293.eng.abstr-s2-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r20-t4.1-t6.1",
"type": "result_of",
"arg1_id": "IntensiveMedizin.90360293.eng.abstr-s2-t4",
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},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r21-t1.1-t4.1",
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"arg1_id": "IntensiveMedizin.90360293.eng.abstr-s2-t1",
"arg2_id": "IntensiveMedizin.90360293.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r22-t1.1-t8.1",
"type": "result_of",
"arg1_id": "IntensiveMedizin.90360293.eng.abstr-s2-t1",
"arg2_id": "IntensiveMedizin.90360293.eng.abstr-s2-t8",
"normalized": []
},
{
"id": "IntensiveMedizin.90360293.eng.abstr-s2-r23-t6.1-t4.1",
"type": "degree_of",
"arg1_id": "IntensiveMedizin.90360293.eng.abstr-s2-t6",
"arg2_id": "IntensiveMedizin.90360293.eng.abstr-s2-t4",
"normalized": []
}
] |
IntensiveMedizin.90360300.eng.abstr
|
IntensiveMedizin.90360300.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360300.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 46 year old woman suffered from a subarachnoid hemorrhage caused by a \" giant \" aneurysm of the right internal carotid artery which was followed by acute circulatory insufficiency with left heart failure . It was not possible to restore stable blood pressure in spite of therapy with different catecholamines and invasive cardiocirculatory monitoring , until the use of the phosphodiesterase-inhibitor enoximon achieved a significant increase of cardiac output and an improvement of the hemodynamic parameters . Because of the infraclinoidal position of the aneurysm , endovascular treatment was favored , but could not be performed because of a lethal rebleeding on day 19 of the primary event . In neurogenic caused left heart failure , phosphodiesterase-inhibitors may improve cardiac output and consecutive cerebral perfusion pressure ."
],
"offsets": [
[
0,
842
]
]
}
] |
[
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"old"
],
"offsets": [
[
10,
13
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0331059"
}
]
},
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"woman"
],
"offsets": [
[
14,
19
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0043210"
}
]
},
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"hemorrhage"
],
"offsets": [
[
49,
59
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019080"
}
]
},
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"giant"
],
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[
74,
79
]
],
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{
"db_name": "UMLS",
"db_id": "C0017547"
}
]
},
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"aneurysm"
],
"offsets": [
[
82,
90
]
],
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{
"db_name": "UMLS",
"db_id": "C0002940"
}
]
},
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"right"
],
"offsets": [
[
98,
103
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0035621"
}
]
},
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"artery"
],
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[
121,
127
]
],
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{
"db_name": "UMLS",
"db_id": "C0003842"
}
]
},
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"heart"
],
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[
192,
197
]
],
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{
"db_name": "UMLS",
"db_id": "C0018787"
}
]
},
{
"id": "IntensiveMedizin.90360300.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"subarachnoid hemorrhage"
],
"offsets": [
[
36,
59
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038525"
}
]
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] |
IntensiveMedizin.90360304.eng.abstr
|
IntensiveMedizin.90360304.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360304.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 57 year old female patient was admitted with acute myocardial infarction of the posterior wall . In the angiography of the coronary arteries , a dissection of the right coronary artery was found . The vessel was successfully recanalized by implantation of two stents . Further diagnostics showed a dissected aneurysm of the aorta ascendens ( Stanford type A ) and a bicuspid aortic valve ."
],
"offsets": [
[
0,
391
]
]
}
] |
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{
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"id": "IntensiveMedizin.90360304.eng.abstr-s4-t2",
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[] |
[] |
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] |
IntensiveMedizin.90360309.eng.abstr
|
IntensiveMedizin.90360309.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360309.eng.abstr-passage-0",
"type": "abstract",
"text": [
"At present there is a noticable trend in the literature and clinical practise that different medical specialities prefer various procedures of tracheostomy in intensive care medicine rather onesided and without consensus of opinion . In result of effective cooperation between ENT department and surgical and medical intensive care units in planning and realization , there were 239 tracheostomies of different techniques performed ; due to these experiences clear indications for the varying methods became obvious . The indications are based on both the history of present illness and its course and the contraindications of percutaneous tracheostomy methods . In comparison of 3147 conventional surgical and 2124 percutaneous tracheostomies the perioperative complication rate is almost indentical . Therefore , it seems impossible to draw a conclusion in favor of one method at present time ."
],
"offsets": [
[
0,
896
]
]
}
] |
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IntensiveMedizin.90360349.eng.abstr
|
IntensiveMedizin.90360349.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360349.eng.abstr-passage-0",
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"text": [
"Catheter-related bloodstream infection is the most common life threatening complication of intravascular catheters . Most cases of catheter-related infection are caused by skin organisms that originate either from the skin of the patient and migrate along the external surface of the catheter or from the skin of the medical personnel causing hub contamination and subsequent bacterial migration along the internal surface of the catheter . A number of measures have been reported in clinical trials to protect against vascular catheter-related infection . Preventive measures that utilize antimicrobial agents include application of topical disinfectants , flushing catheters with the combination of antimicrobial and antithrombotic agents , use of silver-impregnated subcutaneous cuffs for short-term central venous catheters , antimicrobial coating of catheters either with antiseptics or with antibiotics , and use of an antiseptic catheter hub . Protective measures that do not utilize antimicrobial agents include placement and maintenance of vascular catheters by a skilled infusion therapy team and institution of maximal sterile barriers ."
],
"offsets": [
[
0,
1148
]
]
}
] |
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"id": "IntensiveMedizin.90360349.eng.abstr-s2-t5",
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[] |
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IntensiveMedizin.90360355.eng.abstr
|
IntensiveMedizin.90360355.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360355.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Metabolic acidosis is a primary disturbance in acid-base physiology characterized by either a gain of H+ or a loss of HCO-3. The distinction is not trivial , since a gain in H+ is an emergency which may be life threatening . The anion gap , Na+-(Cl+HCO-3), is very helpful in this regard , since gain of H+ disturbances are almost invariably non-chloride in nature . Thus , for every 1 mmol/L decrease in HCO-3 an increase of 1 mmol/L in the anion gap would be expected . On the other hand , disturbances which involve loss of HCO-3 via the gastrointestinal tract or which feature failure of the kidney to reclaim or generate HCO-3 appropriately are characterized by increased renal Cl- reabsorption and result in a normal anion gap . We recently encountered a patient with severe metabolic acidosis who was misdiagnosed because his physicians could not make this distinction . The first steps in evaluating any metabolic acidosis should include calculating the anion gap . Further , since acid-base disturbances are frequently multifactorial , the anion gap should be calculated in all acid-base disturbances , irrespective of cause ."
],
"offsets": [
[
0,
1135
]
]
}
] |
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]
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},
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"id": "IntensiveMedizin.90360355.eng.abstr-s1-t2",
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],
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56
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{
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},
{
"id": "IntensiveMedizin.90360355.eng.abstr-s1-t4",
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"id": "IntensiveMedizin.90360355.eng.abstr-s1-t5",
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{
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{
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IntensiveMedizin.90360361.eng.abstr
|
IntensiveMedizin.90360361.eng.abstr
|
[
{
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"type": "abstract",
"text": [
"Hyperkalemia is a frequent disturbance . When hyperkalemia is associated with a rapid rise of the serum potassium concentration , the risk of cardiac impairment is greatest . Usually the cooperative action of several causative factors is required to bring about a hyperkalemia . They are often iatrogenic . Increasing age , diabetes mellitus , disorders of the renin-angiotensin-aldosterone-system , high-dose antibiotics , and immunsuppressive treatments may result in hyperkalemia . The most important pathogenetic mechanisms are ( 1 ) renal insufficiency , ( 2 ) hyporeninemic hypoaldeosteronism , ( 3 ) tubular disorders , and ( 4 ) cellular disorders ."
],
"offsets": [
[
0,
657
]
]
}
] |
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] |
IntensiveMedizin.90360367.eng.abstr
|
IntensiveMedizin.90360367.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360367.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Since the middle of the 1980s , ? reports of invasive infections caused by streptococcus pyogenes are increasing world wide . In a retrospective study the frequency , symptoms , course , therapeutic possibilities , and microbiological characterization of this disease were examined . In the study , all 10 patients ( seven females/ three males , average age 45.0 [ 4-71 ] ) of the district hospital of Reutlingen were included who had a proven streptococcus pyogenes infection between Sept . 1994 and May 1996 , defined by isolation of group A streptococci from a sterile site . Isolates were analyzed for serotype and production of exotoxins in the National Reference Center ( Jena ) of that time . In relation to the approx . 272,000 inhabitants of the district of Reutlingen , our numbers for invasive infections are within the range of the data established in the USA on population-based studies ( incidence between 1.5 to 4.3 per 100,000 ) . In seven patients , ? influenza-like symptoms were observed previous to the acute deterioration of the disease . There was a conspicuous accumulation of the severe courses of toxic shock-like syndrome ( TSLS ) with the following criteria : shock , multiorgan failure , soft tissue necrosis , and generalized erythema ( n=6). All surviving patients with TSLS had to be treated during several days with assisted respiration ( 7-16 days ) . One female patient with TSLS died on the day of admittance due to an intensive septic shock . In the analysis of the isolated strains , ? no uniform results regarding the serotypes and the production of exotoxins were found . The following therapeutic measures are required immediately : antibiotic treatment , surgical treatment of the infective focus , and the established intensive care therapy in cases with multiorgan failure . The observed prodromal symptoms underline emphatically the possibility of an early intervention in the course of the disease ."
],
"offsets": [
[
0,
1944
]
]
}
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}
] |
IntensiveMedizin.90360375.eng.abstr
|
IntensiveMedizin.90360375.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360375.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The incidence of coronary artery aneurysm varies in the range from 0.2% to 4.9% . Ninety per cent of these were associated with atherosclerotic coronary artery disease , where vessel ectasia and poststenotic dilatations are not an infrequent finding . We present the case of a 67 year old patient with coronary artery aneurysm and coexisting coronary artery disease of the right coronary artery . The patient was symptomatic and had a posterolateral myocardial infarction . We performed a PTCA and stent-implantation of the stenosis and coronary artery aneurysm of the right coronary artery . After the procedure , the patient could be discharged without angina pectoris . A control-angiography will be performed six months later ."
],
"offsets": [
[
0,
731
]
]
}
] |
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}
] |
[] |
[] |
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IntensiveMedizin.90360393.eng.abstr
|
IntensiveMedizin.90360393.eng.abstr
|
[
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],
"offsets": [
[
0,
368
]
]
}
] |
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] |
[] |
[] |
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IntensiveMedizin.90360419.eng.abstr
|
IntensiveMedizin.90360419.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360419.eng.abstr-passage-0",
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"text": [
"Sepsis and its potential degradation into multiple organ failure , reflects a complex immunological process occurring system wide , fueled by local and systemic proinflammatory stimuli , the activity of which is only minimally reflected in the levels of pro- and anti-inflammatory mediators found in the blood . On a cellular level , sepsis encompasses the up-regulation of both pro- and anti-inflammatory pathways . Inflammation is augmented through activation of the intracellular promoter protein nuclear factor B ( NF-B ) , which induces synthesis of mRNA coding for many of the pro-inflammatory mediators , including TNF- , IL-8, and inducible nitric oxide synthase . Similarly , the same stimuli also produce parallel activation of the heat shock protein ( hsp ) pathways that inhibit NF-B activation and minimize the inflammatory response . It is the balance between these two pathways that appears to determine the immune responsiveness of the cells both locally and system wide . By characterizing this immune responsiveness , one may understand better the determinants of the ultimate inflammatory response and potential immunotherapy ."
],
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0,
1146
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]
}
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[] |
[] |
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IntensiveMedizin.90360429.eng.abstr
|
IntensiveMedizin.90360429.eng.abstr
|
[
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"The process of weaning , if poorly organized , adds additional time to the duration of mechanical ventilation . Recent prospective studies have shown that the implementation of a protocol-directed weaning leads to an earlier initiation of the weaning process and a significant reduction in the duration of mechanical ventilation . Both daily screening of the respiratory function and trials of spontaneous breathing are valuable tools that should be incorporated into a weaning protocol . Extubation of the ventilated patients as soon as their recovery and ability to spontaneously breath are documented should be encouraged , because there is sufficient evidence that 65-70% of ventilated patients can be successfully extubated after a trial of spontaneous breathing is attempted . A gradual withdrawal of mechanical ventilation can be attempted in patients failing spontaneous breathing trials . Two randomized studies have found that the strategy used to discontinue mechanical ventilation influences the rate and degree of weaning success and that SIMV is the least efficient technique of weaning ."
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0,
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[] |
[] |
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IntensiveMedizin.90360436.eng.abstr
|
IntensiveMedizin.90360436.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360436.eng.abstr-passage-0",
"type": "abstract",
"text": [
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],
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[
0,
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]
}
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{
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}
]
}
] |
[] |
[] |
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] |
IntensiveMedizin.90360446.eng.abstr
|
IntensiveMedizin.90360446.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360446.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In general , assessment of the correct placement of a central venous catheter is performed by fluoroscopy or by postinsertional chest X-ray . We report a case of intraaortic malposition of a central venous catheter in a 59-year-old male patient that was not detectable in chest films . Further exploration of this patient revealed a left-sided superior vena cava ."
],
"offsets": [
[
0,
364
]
]
}
] |
[
{
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"id": "IntensiveMedizin.90360446.eng.abstr-s1-t2",
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"id": "IntensiveMedizin.90360446.eng.abstr-s1-t4",
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"id": "IntensiveMedizin.90360446.eng.abstr-s1-t5",
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{
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"id": "IntensiveMedizin.90360446.eng.abstr-s2-t2",
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{
"id": "IntensiveMedizin.90360446.eng.abstr-s2-t5",
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{
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{
"id": "IntensiveMedizin.90360446.eng.abstr-s3-t3",
"type": "umlsterm",
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353,
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},
{
"id": "IntensiveMedizin.90360446.eng.abstr-s3-t4",
"type": "umlsterm",
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344,
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],
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"db_name": "UMLS",
"db_id": "C0042459"
}
]
}
] |
[] |
[] |
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IntensiveMedizin.90360449.eng.abstr
|
IntensiveMedizin.90360449.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360449.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Up to 3% of patients receiving unfractionated heparin develop heparin-induced thrombocytopenia with sometimes severe thromboembolic complications , the treatment of which is difficult . We report on a patient with gastric carcinoma , who received 5000 IU of unfractionated heparin s.c. tid after having gastrectomy , splenectomy , and partial pancreatectomy . From the 10th postoperative day the platelet count fell to a minimum of 65000/µl on day 21. Complaining of dyspnea and tachycardia , she was diagnosed with stage III bilateral pulmonary embolism complicating heparin-induced thrombocytopenia type II ( HIT II ) . Treatment with lepirudin ( Refludan ) did not result in rapid improvement . Therefore , fibrinolysis with alteplase ( 30 mg of Actilyse ) via the pulmonary catheter was instituted , which resulted in a decline of pulmonary arterial pressure to less than 20 mmHg as well as in an improvement of scintigraphy and clinical symptoms . A scintigram performed 4 weeks later showed almost complete reperfusion . The HIPA test was positive . In conclusion , a hemodynamically compromising pulmonary embolism occurring in HIT II can be treated with alteplase as a fibrinolytic agent even after recent major abdominal surgery . In the case presented here the diagnosis might have been obscured by the preceding splenectomy ."
],
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[
0,
1336
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}
] |
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] |
[] |
[] |
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IntensiveMedizin.90360454.eng.abstr
|
IntensiveMedizin.90360454.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360454.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 35-year-old man with known hyperthyroidism because of a toxic multinodular goiter developed thyrotoxic crisis with various organ failures . Antithyroidal drug-treatment was stopped two weeks prior to admission under the assumption of drug induced thrombozytopenia . Iodine exposure could be excluded . Laboratory findings showed elevated thyroid hormone levels ( TT3 7.39 nmol/l , TT4 192.5 nmol/l , TSH-basal 0.00 U/l ) . Additional findings were thrombozytopenia ( 32000/nl), hyponatriaemia ( 131 mmol/l ) , and disseminated intravascular coagulation ( Quick 14% , PTT 113 s , ATIII 78% , fibrin degradation products > 40 µg/ml). Chest radiography revealed cardiomegaly with pulmonary edema ; the ECG showed atrial fibrillation ( ventricular rate 180/min). In this instable clinical situation , the patient underwent emergency subtotal thyroidectomy ( near total resection ) 12 h after resuscitation . After the thyreoidectomy , the clinical situation quickly improved ; thyroid hormon levels normalized . Four days after surgery , intravenous L-thyroxine substitution was necessary ( 100 µg L-thyroxine i.v. /24 h ) . After two weeks of hemodialysis , the kidney function was restored . Eight weeks later the patient was dismissed with the treatment of 150 µg L-thyroxine per day . Thyrotoxic crisis is a rare , life-threatening complication of hyperthyroidism . The important characteristic is not the thyroid blood hormone level , but the life-threatening situation for the patient . Thyrotoxic crisis may be one reason for hyperdynamic shock . Thrombozytopenia is a common side effect in thyrotoxic crisis . Emergency subtotal thyreoidectomy within the first 48 h is considered to be the best method to control the crisis ."
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] |
[] |
[] |
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] |
IntensiveMedizin.90360462.eng.abstr
|
IntensiveMedizin.90360462.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360462.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Poisoning due to tricyclic antidepressant ( TCA ) ingestion is both a common and serious emergency in Germany . Regarding the widespread activity of TCA , interference with many different organ systems occurs . Besides complications of cerebral and pulmonary function , cardiac arrhythmias are seen as a dangerous effect of TCA intoxication . The mechanisms of pathophysiology in organ damage following TCA intoxication are discussed and an overview on the specific therapy and detoxication is given ."
],
"offsets": [
[
0,
501
]
]
}
] |
[
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],
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0,
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],
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},
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"db_id": "C0032344"
}
]
},
{
"id": "IntensiveMedizin.90360462.eng.abstr-s1-t2",
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],
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27,
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{
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"TCA"
],
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"emergency"
],
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{
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{
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{
"id": "IntensiveMedizin.90360462.eng.abstr-s3-t3",
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"text": [
"arrhythmias"
],
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278,
289
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},
{
"id": "IntensiveMedizin.90360462.eng.abstr-s3-t4",
"type": "umlsterm",
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"TCA"
],
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327
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"id": "IntensiveMedizin.90360462.eng.abstr-s3-t5",
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]
},
{
"id": "IntensiveMedizin.90360462.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"cardiac arrhythmias"
],
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[
270,
289
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],
"normalized": [
{
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"db_id": "C0003811"
}
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},
{
"id": "IntensiveMedizin.90360462.eng.abstr-s4-t1",
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"text": [
"pathophysiology"
],
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"db_id": "C0031847"
}
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},
{
"id": "IntensiveMedizin.90360462.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"TCA"
],
"offsets": [
[
403,
406
]
],
"normalized": [
{
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},
{
"id": "IntensiveMedizin.90360462.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
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],
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407,
419
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{
"id": "IntensiveMedizin.90360462.eng.abstr-s4-t4",
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"text": [
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"db_id": "C0039798"
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]
}
] |
[] |
[] |
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] |
IntensiveMedizin.90360493.eng.abstr
|
IntensiveMedizin.90360493.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360493.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Procalcitonin is a propeptide of calcitonin . It is usually not detectable in healthy volunteers but appears in high concentrations in the serum of patients with severe bacterial , parasitic or fungal infection . In contrast , procalcitonin levels do not or only moderately increase during viral infections or during non-infectious systemic inflammatory states . Because of these properties , procalcitonin has been proposed to serve as a marker of severe infections and sepsis . Increased procalcitonin levels have recently been shown to indicate the severity of systemic infection with increasing specificity . Normally , procalcitonin is produced in the C-cells of the thyroid gland . The origin of the high levels of procalcitonin in septic conditions is not fully understood . Although procalcitonin has drawn attention as a marker of severe systemic infections , a recent study suggests it may also be a mediator of sepsis . More studies are needed to uncover the nature and pathophysiological role of this molecule ."
],
"offsets": [
[
0,
1023
]
]
}
] |
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] |
IntensiveMedizin.90360514.eng.abstr
|
IntensiveMedizin.90360514.eng.abstr
|
[
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"text": [
"Infectious complications related to acquired neutropenia have become a major medical issue , often requiring intensive care management . These infections may be lethal if empirical broad-spectrum treatment is not rapidly started at the first sign of infection ( i.e. , fever ) , and this concept is now widely recognized a standard practice . However , the choice of antibiotics has generated considerable controversy for nearly 25 years . After reviewing some particularities of infection in neutropenic patients , this paper will discuss the options and present comprehensive algorithm for non-infectious diseases specialist , including recent advances about early IV-oral switch and the selection of low risk patients for outpatient management ."
],
"offsets": [
[
0,
748
]
]
}
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] |
IntensiveMedizin.90360526.eng.abstr
|
IntensiveMedizin.90360526.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360526.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Nosocomial infections diminish the prognosis and clinical outcome of patients with acute stroke . This retrospective study was performed to investigate epidemiological data and risk factors for the development of nosocomial pneumonia in 50 patients ( 25 supra- and 25 infratentorial acute infarctions ) treated in a neurological ICU . A total pneumonia incidence of 42% ( 21/150 ) was observed . In 19 cases ( 85% ) , the diagnostic criteria of early-onset pneumonia were fulfilled , and 15 of 19 patients were mechanically ventilated . The incidence of pneumonia was significantly higher in infratentorial infarctions . Compared to supratentorial ischemic lesions , patients with HI-infra presented with a significant higher disturbance of consciousness ( assessed with the Glasgow Coma Scale ) and severity of the disease ( assessed with the APACHE II Scale ) . Besides poor performance in GCS and APACHE II , the necessity of early endotracheal intubation and the presence of infratentorial infarction were identified as risk factors for nosocomial pneumonia in acute stroke . Our results demonstrate the pathogenetic relevance of altered consciousness presumably leading to tracheal aspiration . For clinical concerns , stroke patients with infratentorial infarction and impaired consciousness should be classified as a high-risk group and receive intensive prophylactic treatment ."
],
"offsets": [
[
0,
1386
]
]
}
] |
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IntensiveMedizin.90360534.eng.abstr
|
IntensiveMedizin.90360534.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360534.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report on a 29 year old female patient with recurrent syncope , QT-prolongation as well as documented torsade de pointes tachycardia , who was diagnosed as having a long QT-syndrome . Since the patient was treated with the macrolide antibiotic Clarithromycin shortly before the first syncope and it is known that Erythromycin , a drug of the same group , can lead to QT-prolongation and torsade de pointes tachycardia , the differential diagnosis between the acquired and the congenital form of the long QT-syndrome needed to be established . No prior ECGs existed . Because of persisting QT-prolongation more than six months after discontinuation of Clarithromycin therapy and QT-prolongation of the QT-interval in the patients's uncle's ECG , we diagnosed a congenital form of the long QT-syndrome . The patient is treated with a beta blocker and has been asymptomatic since then . From the case report , we discuss the features of the long QT-syndrome , its differential diagnoses , and treatment options ."
],
"offsets": [
[
0,
1012
]
]
}
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] |
[] |
[] |
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IntensiveMedizin.90360541.eng.abstr
|
IntensiveMedizin.90360541.eng.abstr
|
[
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"text": [
"Ethylene dichloride ( EDC ) is used as a solvent and in the rubber , plastic , and insecticide industry . The fatal adult dose is below 20 ml . Poisoning can occur from inhalation , ingestion or skin absorption . EDC depresses almost all cells , but essentially those of the central nervous system , liver , kidneys , and heart . Death is usually due to liver or central nervous failure ."
],
"offsets": [
[
0,
388
]
]
}
] |
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153
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},
{
"id": "IntensiveMedizin.90360541.eng.abstr-s3-t2",
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IntensiveMedizin.90360606.eng.abstr
|
IntensiveMedizin.90360606.eng.abstr
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"In the USA , recombinant tissue plasminogen activator ( rt-PA ) has been approved for therapy of acute ischemic stroke ( AIS ) within a 3 hour time window based on the results of the NINDS [ 1 ] trial . Only few patients with AIS are referred to a hospital within three hours after onset of symptoms , and only 3% of these patients qualify for treatment with rt-PA . Therefore , only few patients with AIS will potentially benefit from therapy with rt-PA if NINDS criteria are applied . The goal of the Second European-Australasian Acute Stroke Study ( ECASS II ) was to evaluate safety and efficacy of thrombolytic therapy with rt-PA in AIS for a 6 hour time window ."
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IntensiveMedizin.90360612.eng.abstr
|
IntensiveMedizin.90360612.eng.abstr
|
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"The review shows the development in the prophylactics and therapy of methicillin ( multi ) -resistant Staphylococcus aureus ( MRSA ) and the lately emergenced vancomycin-resistant Staphylococcus aureus ( VRSA ) strains the lately emergenced . A state of the art decontamination and isolation guideline with a special emphasis on critical care patients is given . Also the article reviews the currently used antibiotic drugs for local and systemic treatment of MRSA infection . The most important systemic administered drugs are discussed with a focus on glycopeptides . Quinupristin/ Dalfopristin ( Synercid , RP 59500 ) as a substance , which is currently being clinically investigated and is close to its registration , is also introduced and quoted ."
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[] |
[] |
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] |
IntensiveMedizin.90360619.eng.abstr
|
IntensiveMedizin.90360619.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360619.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Skeletal muscle protein breakdown is a dominant feature of critical illness and is believed to be a useful biological response to injury . However the loss of muscle is accompanied by some major difficulties in medical management and complications for the patient . Protein turnover is difficult to study and the catabolic state is resistant to treatment , whether by nutritional or other strategies . This article provides an overview of the current physiological knowledge in this area , questions the usefulness of the catabolic response and highlights some new research worthy of further investigation ."
],
"offsets": [
[
0,
607
]
]
}
] |
[
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{
"id": "IntensiveMedizin.90360619.eng.abstr-s1-t4",
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},
{
"id": "IntensiveMedizin.90360619.eng.abstr-s3-t1",
"type": "umlsterm",
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],
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"id": "IntensiveMedizin.90360619.eng.abstr-s3-t2",
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{
"id": "IntensiveMedizin.90360619.eng.abstr-s3-t3",
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{
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"db_id": "C0035168"
}
]
}
] |
[] |
[] |
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] |
IntensiveMedizin.90360635.eng.abstr
|
IntensiveMedizin.90360635.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360635.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Neurocognitive disorders are often the reason to call for an emergency physician . We report on a 71 year old male patient who showed a sudden sensorial clouding caused by an uremic encephalopathy . The patient was admitted to the intensive car unit . During the following two days he underwent three emergency hemodialysis sessions until renal function recovered . Further investigations revealed as hydronephrosis secondary to a benign prostatic hypertrophy as the cause of acute renal failure ."
],
"offsets": [
[
0,
497
]
]
}
] |
[
{
"id": "IntensiveMedizin.90360635.eng.abstr-s1-t1",
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"disorders"
],
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15,
24
]
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{
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"db_id": "C0012634"
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{
"id": "IntensiveMedizin.90360635.eng.abstr-s1-t2",
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"emergency"
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],
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}
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{
"id": "IntensiveMedizin.90360635.eng.abstr-s1-t3",
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"physician"
],
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80
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],
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},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s2-t1",
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"text": [
"old"
],
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]
],
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{
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},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s2-t2",
"type": "umlsterm",
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"male"
],
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110,
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}
]
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{
"id": "IntensiveMedizin.90360635.eng.abstr-s2-t3",
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"patient"
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"db_id": "C0030705"
}
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{
"id": "IntensiveMedizin.90360635.eng.abstr-s3-t1",
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"patient"
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210
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"db_id": "C0030705"
}
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{
"id": "IntensiveMedizin.90360635.eng.abstr-s3-t2",
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"car"
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"db_id": "C0007297"
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"db_id": "C0004381"
}
]
},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s4-t1",
"type": "umlsterm",
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"emergency"
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301,
310
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{
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"db_id": "C0013956"
}
]
},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"hemodialysis"
],
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[
311,
323
]
],
"normalized": [
{
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"db_id": "C0019004"
}
]
},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"function"
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[
345,
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"db_id": "C0031843"
}
]
},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s5-t1",
"type": "umlsterm",
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],
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],
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"db_id": "C0020295"
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},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"secondary"
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"db_id": "C0027627"
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"db_id": "C0036525"
}
]
},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"hypertrophy"
],
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"db_id": "C0020564"
}
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{
"id": "IntensiveMedizin.90360635.eng.abstr-s5-t4",
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"db_id": "C0015127"
}
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},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s5-t5",
"type": "umlsterm",
"text": [
"prostatic hypertrophy"
],
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438,
459
]
],
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"db_id": "C0005001"
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}
]
},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s5-t6",
"type": "umlsterm",
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"db_id": "C0035078"
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},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s5-t7",
"type": "umlsterm",
"text": [
"benign prostatic hypertrophy"
],
"offsets": [
[
431,
459
]
],
"normalized": [
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"db_name": "UMLS",
"db_id": "C0005001"
}
]
},
{
"id": "IntensiveMedizin.90360635.eng.abstr-s5-t8",
"type": "umlsterm",
"text": [
"acute renal failure"
],
"offsets": [
[
476,
495
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022660"
}
]
}
] |
[] |
[] |
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IntensiveMedizin.90360642.eng.abstr
|
IntensiveMedizin.90360642.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360642.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Myocardial infarctions may be precipitated by external triggers . External triggers include physical activity and emotional stress as well as other infrequent triggers such as war threats or earthquakes . Changes in the environment also play an important role in the incidence of myocardial infarctions ; circadian , seasonal , and weekly variations have been observed . Patients ' behavior at the onset of symptoms depends on various factors and influences outcome and mortality . Appropriate preventive measures are indicated in order to protect patients during vulnerable periods . Health education should be directed towards patients ' behavior and promptly seeking medical assistance at the onset of symptoms ."
],
"offsets": [
[
0,
715
]
]
}
] |
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{
"id": "IntensiveMedizin.90360642.eng.abstr-s3-t4",
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[] |
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] |
IntensiveMedizin.90360662.eng.abstr
|
IntensiveMedizin.90360662.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360662.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Today echocardiography is the noninvasive method of choice for routinely and urgently performed cardiologic diagnostics . Echo enhancing agents are suited to lessen the restrictions of tm , Doppler , and color Doppler echocardiography by physics and to better visualize the problems resolving . In the meantime , there are different echo enhancing agents available for contrast echocardiography of right and left heart chambers . The article describes the application of contrast echocardiography striking the cardiologist in emergency and intensive care medicine . In pericardial tamponade or difficult pericardiocentesis , contrast echocardiography allows one to better distinguish between free epicardial and surrounded pericardial site of right atrium and ventricle . The use of native and color Doppler contrast echocardiography has increased the sensitivity and specifity in diagnosing an atrial septal defect or a patent foramen ovale . Today it is the standard technique for this indication . Contrast enhancers significantly improve the noninvasive echocardiographic assessment of normal and pathologic intracardiac flow and are capable of accurately determining intracardiac velocities and pressure gradients . Contrast transthoracic echocardiography is currently used to identify intrapulmonary shunts in patients with end-stage liver disease and expected hepatopulmonary syndrome . After myocardial infarction with imminent rupture or surgical left ventricular reduction contrast echocardiography may help to better appreciate the stability of the myocardium . The number of diagnostically utilizable Doppler signals can be significantly increased by using left ventricular contrast medium in diagnosis of aortic valve stenosis by means of Doppler echocardiography ."
],
"offsets": [
[
0,
1778
]
]
}
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IntensiveMedizin.90360677.eng.abstr
|
IntensiveMedizin.90360677.eng.abstr
|
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"Recognition of the potential for ventilator-associated lung injury in patients with acute respiratory distress syndrome ( ARDS ) has stimulated the debate on the appropriate strategies of mechanical ventilation in these patients . This review summarizes new aspects of research on ventilator-associated lung injury and provides an overview of recent prospective , randomized , controlled trials . Methods and principles guiding ventilatory support like pressure-limited mechanical ventilation with low tidal volumes and high levels of positive end-expiratory pressure ( PEEP ) as well as adjunctive , non-ventilatory therapies like inhaled nitric oxide ( NO ) or administration of exogenous surfactant are discussed ."
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}
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] |
[] |
[] |
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] |
IntensiveMedizin.90360702.eng.abstr
|
IntensiveMedizin.90360702.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360702.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Cytokines are inflammatory response mediators . Pro-inflammatory cytokines ( interleukin-6, interleukin-8, TNF- ) promote inflammation by recruitment of cells while others decrease the inflammatory response ( e.g. , interleukin-10). The role of cytokines in inflammatory lung disease has been widely investigated and this review tries to clarify the important question whether cytokine levels , in serum or bronchoalveolar lavage fluid , may help to distinguish adult respiratory distress syndrome ( ARDS ) from pneumonia in patients with bilateral pulmonary infiltrates ."
],
"offsets": [
[
0,
572
]
]
}
] |
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{
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"id": "IntensiveMedizin.90360702.eng.abstr-s2-t18",
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] |
[] |
[] |
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] |
IntensiveMedizin.90360709.eng.abstr
|
IntensiveMedizin.90360709.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360709.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Purpose : This retrospective study was designed to evaluate the incidence and clinical significance of pathological findings on abdominal CT scans in patients with ARDS . Material and methods : CT scans of 92 patients ( female 40.2% , mean age : 32 years ) with ARDS were analyzed retrospectively . The impact of pathological findings on the course and prognosis was evaluated employing the duration of ventilation , the Lung Injury Score , the need for ECMO , the incidence of multiple organ failure and the overall lethality as measurable parameters . Results : Pathological findings on CT scans were detected in 75 ( 82% ) of 92 patients . Hepatomegaly was the most common finding ( n=48, 52% ) . Free abdominal fluid was detected in 29 ( 31% ) and splenomegaly in 25 ( 27% ) cases . Peritoneal and retro-peritoneal infiltrations as well as bowl wall thickening , dilated bile ducts , and I ° or II ° pancreatitis were less common findings . The overall lethality in patients with pathological findings was about twice as high ( 23% ) as compared to those without ( 12% ) . Conclusions : The prevalence of pathological findings on abdominal CT is a reliable indicator of an unfavorable course and outcome in patients with ARDS ."
],
"offsets": [
[
0,
1231
]
]
}
] |
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IntensiveMedizin.90360714.eng.abstr
|
IntensiveMedizin.90360714.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360714.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The opsoclonus-myoclonus syndrome is a rare brain-lesion of paraneoplastic or paraviral origin . Generalized action-myoclonus and the opsoclonus , a distinct ocular dyskinesia consisting of quick , involuntary movements of the eyeballs are the hallmarks of the disease . We describe the clinical course of a 63 year old man from our institution . After non-specific prodromal symptoms , he developed the main clinical signs opsoclonus and myoclonus . The course was rapidly progressive up to respiratory failure . All therapeutic efforts were unsuccessful . Only autopsy uncovered the underlying disease , a small cell carcinoma of the lung . Using the clinical presentation as an example the diagnostic and therapeutic options of the opsoclonus-myoclonus syndrome are discussed . To our knowledge this is the first report of a patient with this syndrome , who was treated with artificial respiration ."
],
"offsets": [
[
0,
902
]
]
}
] |
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}
] |
[] |
[] |
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IntensiveMedizin.90360718.eng.abstr
|
IntensiveMedizin.90360718.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360718.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report three cases of Jimson weed poisoning that we treated at an intermediate care ward . All three patients ingested the poison intentionally to experience a state of euphoria/hallucinations . Clinically , the central symptoms of the anticholinergic syndrome were the most striking features . The patients ' symptoms were characterized by disorientation , hallucinations , and helplessness . Two of the three patients we treated with the antidote Physostigmine . In spite of its short half-life , repeated injections were not necessary . Plants , containing Tropa-alcaloids like Jimson weed and Angel's trumpet are easy to find when in season and have been known as hallucinogenic drugs for long time . The dosage is hard to assess , because of various concentrations in the different parts of the plants . It is easy to recognize the symptoms of intoxication . Except of already existing breathing paralysis , the treatment is easy and impressive within the realm of inpatient circumstances and with the option of ECG-monitoring ."
],
"offsets": [
[
0,
1036
]
]
}
] |
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"id": "IntensiveMedizin.90360718.eng.abstr-s5-t2",
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"id": "IntensiveMedizin.90360718.eng.abstr-s7-t2",
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] |
[] |
[] |
[
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"type": "affects",
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] |
IntensiveMedizin.90360727.eng.abstr
|
IntensiveMedizin.90360727.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360727.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Prehospital diagnosis and first line therapy of acute chest pain are among the most frequently encountered challenges for general practitioners and emergency physicians . Acute myocardial infarction or acute coronary syndromes in general are present in about a third of patients complaining of acute chest pain . The basis of first line therapy is the understanding of the pathophysiology of myocardial ischemia , the clinical symptoms , the diagnostic tools and the preclinically available therapeutic options . Time is the most critical factor in myocardial ischemia and subsequent infarction with irreversible injury of subendocardial cells starting within 30-60 minutes of total myocardial ischemia and with transmural infarction becoming complete in 3 to 6 hours . With 30% of patients dying within the first hour of ischemia mostly due to ventricular arrhyhtmias every effort needs to be made to shorten the delay between symptom onset and start of reperfusion therapy . The present overview concentrates on the armamentarium of preclincial diagnosis and the options of first line therapy of myocardial infarction with the aim of a short transport time to the hospital and therefore a short delay to more specific therapies like thrombolysis or PTCA ."
],
"offsets": [
[
0,
1257
]
]
}
] |
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"id": "IntensiveMedizin.90360727.eng.abstr-s2-t6",
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[] |
[] |
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IntensiveMedizin.90360737.eng.abstr
|
IntensiveMedizin.90360737.eng.abstr
|
[
{
"id": "IntensiveMedizin.90360737.eng.abstr-passage-0",
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"text": [
"This contribution summarizes a discussion of experts in the field of bioelectrical impedance analysis , which was held at the Evangelische Akademie Loccum , Germany , May 12-13 , 1999. Body composition can be most adequately measured by cumbersome methods . For routine use in clinical practice these tools are usually not available and are too expensive . For bedside assessment bioelectrical impedance analysis ( BIA ) is considered a feasible and useful option . Body composition can be calculated from body impedance using formulas developed and validated by standard methods . This discussion in Loccum focused on the reliability of measured and calculated data , as well as their relevance for clinical decision making in nutritional therapy . The experts ' opinion leads to the following statements : The reliability of calculating body composition from body resistance depends on the quality of the formula derived from reference measurements . Due to a shortage of adequate reference data for many diseases , validation of BIA measurement is mandatory for interindividual comparison in defined populations and with special regard to scientific purposes . BIA is useful for intraindividual follow up of body composition . The method is inappropriate to measure extreme shifts of extracellular mass and body water like \" capillary leak syndrome \" in the critically ill. Possible improvement using multifrequency BIA has to be awaited . In order to work out BIA integrated nutritional concepts , further work should focus even more on correlation of measured body impedance data ( resistance , reactance , phase angle ) and clinical outcome in different diseases ."
],
"offsets": [
[
0,
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]
}
] |
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] |
IntensiveMedizin.9036s001.eng.abstr
|
IntensiveMedizin.9036s001.eng.abstr
|
[
{
"id": "IntensiveMedizin.9036s001.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The study of lung mechanics deals with the pressures acting on the respiratory system ( lungs and chest wall ) and the changes in volume that they produce . In mechanical ventilation , the technical gas delivery system ( ventilator , respiratory tubing system , gas humidifier ) and the respiratory system of the patient form a connected pneumatic system of high complexity . The respiratory system produces a mechanical impedance is composed of an elastic and a non-elastic , i.e. , resistive part. The corresponding indices describing respiratory mechanics are compliance and flow resistance . Based on the equation of motion of the respiratory system , the methods of analyzing semistatic compliance and resistance during mechanical ventilation are described . Quantitative analysis of respiratory system mechanics ( a ) is a prerequisite for the understanding of the complex patient-ventilator interaction , ( b ) provides important clinical information on pulmonary function and the course of disease , and ( c ) allows the physician at the bedside to adjust the ventilatory settings to the needs of the individual patient ."
],
"offsets": [
[
0,
1129
]
]
}
] |
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{
"id": "IntensiveMedizin.9036s001.eng.abstr-s2-t2",
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"id": "IntensiveMedizin.9036s001.eng.abstr-s2-t3",
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"delivery"
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211
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"id": "IntensiveMedizin.9036s001.eng.abstr-s2-t5",
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{
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"type": "umlsterm",
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"id": "IntensiveMedizin.9036s001.eng.abstr-s3-t1",
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"impedance"
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] |
[] |
[] |
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},
{
"id": "IntensiveMedizin.9036s001.eng.abstr-s5-r27-t1.1-t5.1",
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},
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"id": "IntensiveMedizin.9036s001.eng.abstr-s5-r33-t1.1-t3.1",
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{
"id": "IntensiveMedizin.9036s001.eng.abstr-s5-r34-t3.1-t5.1",
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"arg2_id": "IntensiveMedizin.9036s001.eng.abstr-s5-t5",
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}
] |
IntensiveMedizin.9036s017.eng.abstr
|
IntensiveMedizin.9036s017.eng.abstr
|
[
{
"id": "IntensiveMedizin.9036s017.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patients with pre-existing respiratory diseases have a significantly higher risk for developing perioperative pulmonary complications than patients with healthy lungs . Most common perioperative respiratory complications are reduction of lung volumes , pneumonia , and bronchospasm , which contribute to increased perioperative morbidity and mortality . Patient's history and clinical examination are the most important measures to identify at-risk patients . Important risk factors for perioperative respiratory complications include chronic respiratory diseases , upper abdominal or thoracic surgery , obesity , and cigarette smoking . Most common pre-existing respiratory diseases are chronic obstructive pulmonary disease ( COPD ) and asthma whereas restrictive lung diseases play a minor role . The incidence of perioperative pulmonary complications can be decreased if the severity of lung function impairment is identified and sufficient measures are implemented either preoperatively or at least postoperatively . This includes the choice of the adequate anesthesia technique as well as the optimal selection of anesthetics ."
],
"offsets": [
[
0,
1133
]
]
}
] |
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"lungs"
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s2-t3",
"type": "umlsterm",
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s2-t4",
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"id": "IntensiveMedizin.9036s017.eng.abstr-s2-t5",
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"type": "umlsterm",
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"id": "IntensiveMedizin.9036s017.eng.abstr-s3-t1",
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s3-t2",
"type": "umlsterm",
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"id": "IntensiveMedizin.9036s017.eng.abstr-s3-t3",
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s4-t5",
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"id": "IntensiveMedizin.9036s017.eng.abstr-s4-t6",
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"type": "umlsterm",
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s5-t2",
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]
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"COPD"
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"asthma"
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"id": "IntensiveMedizin.9036s017.eng.abstr-s5-t5",
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"lung"
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s5-t6",
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s5-t7",
"type": "umlsterm",
"text": [
"minor"
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{
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s5-t9",
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{
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{
"id": "IntensiveMedizin.9036s017.eng.abstr-s6-t4",
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"id": "IntensiveMedizin.9036s017.eng.abstr-s7-t4",
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"id": "IntensiveMedizin.9036s017.eng.abstr-s7-t5",
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"db_name": "UMLS",
"db_id": "C0002932"
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]
}
] |
[] |
[] |
[
{
"id": "IntensiveMedizin.9036s017.eng.abstr-s1-r1-t4.1-t1.1",
"type": "occurs_in",
"arg1_id": "IntensiveMedizin.9036s017.eng.abstr-s7-t4",
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},
{
"id": "IntensiveMedizin.9036s017.eng.abstr-s1-r2-t6.1-t4.1",
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},
{
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},
{
"id": "IntensiveMedizin.9036s017.eng.abstr-s1-r4-t4.1-t2.1",
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{
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},
{
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IntensiveMedizin.9036s022.eng.abstr
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IntensiveMedizin.9036s022.eng.abstr
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"The American-European Consensus Conference recently recommended the following criteria for diagnosis of ARDS : ( 1 ) acute onset ; ( 2 ) PaO2/FiO2 =200 mmHg regardless of PEEP level ; ( 3 ) bilateral infiltrates seen on frontal chest radiograph ; ( 4 ) PCWP = 18 mmHg when measured or no clinical evidence of left atrial hypertension . Pathophysiologically , ARDS is characterized by pulmonary edema owing to injury of the capillary-alveolar membranes and increased pulmonary artery pressure . It is further distinguished by severe hypoxemia unresponsive to the usual methods of support for respiratory failure . Hypoxemia is caused by intrapulmonary right-to-left shunting due to to persistent perfusion of non-ventilated alveoli . Another characteristic feature in ARDS is the low thoracopulmonary compliance . Latest studies suggest that the incidence of the syndrome is in the range of 3-10 cases / 100,000 inhabitants / year . Mortality rates are a major concern : old and new reports continue to report mortality rates of 50-60% ."
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[] |
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"arg2_id": "IntensiveMedizin.9036s022.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s022.eng.abstr-s3-r5-t1.1-t2.2",
"type": "co-occurs_with",
"arg1_id": "IntensiveMedizin.9036s022.eng.abstr-s7-t1",
"arg2_id": "IntensiveMedizin.9036s022.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s022.eng.abstr-s4-r1-t3.1-t1.1",
"type": "location_of",
"arg1_id": "IntensiveMedizin.9036s022.eng.abstr-s7-t3",
"arg2_id": "IntensiveMedizin.9036s022.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s022.eng.abstr-s5-r1-t2.1-t1.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.9036s022.eng.abstr-s7-t2",
"arg2_id": "IntensiveMedizin.9036s022.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s022.eng.abstr-s5-r2-t1.1-t2.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.9036s022.eng.abstr-s7-t1",
"arg2_id": "IntensiveMedizin.9036s022.eng.abstr-s7-t2",
"normalized": []
}
] |
IntensiveMedizin.9036s026.eng.abstr
|
IntensiveMedizin.9036s026.eng.abstr
|
[
{
"id": "IntensiveMedizin.9036s026.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute exacerbation of COPD is most often caused by pulmonary infections . This may necessitate support by mechanical ventilation ( non-invasively via nasal or face mask or invasively via endotracheal tube ) . For ventilation settings and strategy , a profound understanding of the pathophysiological mechanisms is mandatory . The main principles are reducing dynamic pulmonary hyperinflation , decreasing work of breathing by reduction of obstructive load , and avoiding patient-ventilator dyscoordination . Careful and repeated adjustment of the ventilator settings is mandatory . After the acute phase , the weaning process has to be initiated as early as possible ."
],
"offsets": [
[
0,
668
]
]
}
] |
[
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"COPD"
],
"offsets": [
[
22,
26
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0024117"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"infections"
],
"offsets": [
[
61,
71
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021311"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"ventilation"
],
"offsets": [
[
117,
128
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042491"
},
{
"db_name": "UMLS",
"db_id": "C0035203"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"face"
],
"offsets": [
[
159,
163
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0015450"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"mask"
],
"offsets": [
[
164,
168
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0024861"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"mechanical ventilation"
],
"offsets": [
[
106,
128
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042494"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"ventilation"
],
"offsets": [
[
213,
224
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042491"
},
{
"db_name": "UMLS",
"db_id": "C0035203"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"understanding"
],
"offsets": [
[
260,
273
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0162340"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"hyperinflation"
],
"offsets": [
[
377,
391
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021398"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"work"
],
"offsets": [
[
405,
409
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0043227"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"work of breathing"
],
"offsets": [
[
405,
422
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0043229"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"adjustment"
],
"offsets": [
[
529,
539
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0683269"
},
{
"db_name": "UMLS",
"db_id": "C0376209"
}
]
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"ventilator"
],
"offsets": [
[
547,
557
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0087153"
}
]
}
] |
[] |
[] |
[
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s2-r1-t4.1-t1.2",
"type": "affects",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s2-t4",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s2-r2-t4.1-t3.1",
"type": "uses",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s2-t4",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s2-r4-t2.1-t4.1",
"type": "location_of",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t2",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s2-r5-t2.1-t1.2",
"type": "location_of",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t2",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s3-r1-t2.1-t1.1",
"type": "result_of",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t2",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s3-r3-t1.1-t2.1",
"type": "result_of",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s3-r5-t1.2-t2.1",
"type": "result_of",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s3-r6-t2.1-t1.2",
"type": "result_of",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t2",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s4-r1-t1.1-t3.1",
"type": "measurement_of",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s4-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s4-r2-t3.1-t2.1",
"type": "isa",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s4-t3",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s026.eng.abstr-s4-r3-t3.1-t1.1",
"type": "measures",
"arg1_id": "IntensiveMedizin.9036s026.eng.abstr-s4-t3",
"arg2_id": "IntensiveMedizin.9036s026.eng.abstr-s5-t1",
"normalized": []
}
] |
IntensiveMedizin.9036s031.eng.abstr
|
IntensiveMedizin.9036s031.eng.abstr
|
[
{
"id": "IntensiveMedizin.9036s031.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Each lung - even a healthy one - tends to collapse . The goal of \" The Open Lung Concept \" is to reaerate collapsed alveoli and to keep them open . Thus , mechanical ventilation has to aim at recruiting alveoli for gas exchange . This article explains the basics of alveolar physiology and the therapeutic approaches derived from it . In addition , the practical conduct of the alveolar recruitment maneuver is explained for the clinician ."
],
"offsets": [
[
0,
440
]
]
}
] |
[
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"lung"
],
"offsets": [
[
5,
9
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0024109"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"goal"
],
"offsets": [
[
57,
61
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018017"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"Open"
],
"offsets": [
[
71,
75
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0266061"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"Lung"
],
"offsets": [
[
76,
80
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0024109"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"alveoli"
],
"offsets": [
[
116,
123
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0034051"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"open"
],
"offsets": [
[
141,
145
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0266061"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"ventilation"
],
"offsets": [
[
166,
177
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042491"
},
{
"db_name": "UMLS",
"db_id": "C0035203"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"alveoli"
],
"offsets": [
[
203,
210
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0034051"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"gas"
],
"offsets": [
[
215,
218
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0017110"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"mechanical ventilation"
],
"offsets": [
[
155,
177
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042494"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"physiology"
],
"offsets": [
[
275,
285
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0031842"
},
{
"db_name": "UMLS",
"db_id": "C0031843"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"therapeutic"
],
"offsets": [
[
294,
305
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0039796"
}
]
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"conduct"
],
"offsets": [
[
363,
370
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0004927"
}
]
}
] |
[] |
[] |
[
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s2-r1-t4.1-t5.1",
"type": "location_of",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s3-t4",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s2-t5",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s2-r2-t4.1-t2.1",
"type": "location_of",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s3-t4",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s2-r3-t2.1-t5.1",
"type": "location_of",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t2",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s2-t5",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-r1-t4.1-t1.2",
"type": "affects",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s3-t4",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-r2-t1.1-t1.2",
"type": "result_of",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s5-t1",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-r3-t2.1-t4.1",
"type": "location_of",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t2",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s3-t4",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-r4-t3.1-t1.2",
"type": "affects",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s3-t3",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-r5-t2.1-t1.2",
"type": "location_of",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t2",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s3-r6-t1.2-t1.1",
"type": "result_of",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t1",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s4-r1-t1.2-t1.1",
"type": "method_of",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t1",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s5-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.9036s031.eng.abstr-s4-r2-t1.2-t1.1",
"type": "issue_in",
"arg1_id": "IntensiveMedizin.9036s031.eng.abstr-s4-t1",
"arg2_id": "IntensiveMedizin.9036s031.eng.abstr-s5-t1",
"normalized": []
}
] |
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