Intensive care medicine
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Intensive care medicine · Jun 1997
Predictors of mortality and multiple organ failure in children with sepsis.
To assess the markers of perfusion which best discriminate survivors from non-survivors of childhood sepsis and to compare the information derived from gastric tonometry with conventionally measured haemodynamic and laboratory parameters. ⋯ Blood lactate level was the earliest predictor of outcome in children with sepsis. In this group of patients, gastric tonometry added little to the clinical information that could be derived more simply by other means.
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Intensive care medicine · Jun 1997
Is bleomycin-detectable iron present in the plasma of patients with septic shock?
To assess plasma iron status in critically ill patients with septic shock. ⋯ Patients with septic shock rarely have iron saturated transferrin in their plasma leading to the presence of bleomycin-detectable iron.
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Intensive care medicine · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialIntermittent administration of furosemide versus continuous infusion in the postoperative management of children following open heart surgery.
To compare the amount of furosemide needed to fulfil defined criteria for renal output if given intermittently or as a continuous infusion and to compare the effect of these two regimens on hemodynamic variables and urine electrolyte concentrations. ⋯ Intermittent furosemide administration may be recommended in hemodynamically stable postoperative pediatric cardiac patients because of less drug requirement. However, the high maximal urine output may cause hemodynamic problems in patients who depend on high inotropic support.
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Intensive care medicine · Jun 1997
Comparative StudyEffects of high-frequency oscillatory ventilation on circulation in neonates with pulmonary interstitial emphysema or RDS.
Mechanical ventilation may impair cardiovascular function if the transpulmonary pressure rises. Studies on the effects of high-frequency oscillatory ventilation (HFOV) on cardiovascular functions have yielded conflicting results. This study was done to compare alterations in left ventricular output and blood flow velocities in the anterior cerebral artery, internal carotid artery, and celiac artery using a Doppler ultrasound device before and 2 h after initiating HFOV in neonates with respiratory distress syndrome (RDS) or pulmonary interstitial emphysema (PIE). ⋯ The results show that HFOV as used in this study, improves oxygenation, CO2 elimination, and circulation in infants with RDS and PIE. However, systemic, cerebral, and intestinal circulation improved more in neonates with PIE than in those with RDS. This may be due to higher pulmonary compliance in infants with PIE when compared to those with RDS.
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Intensive care medicine · Jun 1997
Comparative StudyDrawover vaporizers for sedation in intensive care.
We have undertaken a laboratory study to determine whether a drawover vaporizer in the inspiratory limb of an intensive care ventilator circuit can produce safe and therapeutic concentrations of isoflurane. ⋯ The experimental findings suggest that the OMV inhaler in plenum mode can be relied upon to produce safe concentrations of isoflurane over a clinically useful range of inspired concentrations. Furthermore, it behaves predictably over the range of airway pressures likely to be encountered in the patient admitted with acute severe asthma. However, we found that the Ohmeda TEC vaporizer did not perform reliably in this setting.