Intensive care medicine
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Intensive care medicine · May 2001
Albumin supplementation during the first week after a burn does not mobilise tissue oedema in humans.
To measure water balance and changes in distribution, and the effect of giving supplementary albumin, early after a burn injury. ⋯ Body water increases after a burn. Excess water is mainly deposited in the extracellular space. Tissue oedema fluid is not mobilised by albumin supplementation.
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Intensive care medicine · May 2001
Effects of tidal volume reduction in acute respiratory distress syndrome on gastric mucosal perfusion.
This study was conducted with the aim of testing the effects of a reduction in tidal volume (V(T)) on gastric mucosal perfusion using laser-Doppler flowmetry in patients with acute respiratory distress syndrome (ARDS). ⋯ V(T) reduction in patients with ARDS, despite resulting in an increase in cardiac output, did not change gastric mucosal perfusion. The heterogeneity in the individual response of GMBF to V(T) reduction could be due to opposite direct (i.e., local vasodilatory effect) and indirect (i.e., global sympathetic stimulation) effects of hypercapnia on gut vessels.
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Intensive care medicine · May 2001
The value of the chloride: sodium ratio in differentiating the aetiology of metabolic acidosis.
Stewart's physicochemical approach to acid-base balance defines the aetiology of a metabolic acidosis by quantifying anions of tissue acids (TA), which consist of unmeasured anions (UMA) and/or lactate. We hypothesised that an increase in TA during metabolic acidosis would lead to a compensatory fall in the plasma chloride (Cl) relative to sodium (Cl:Na ratio) in order to preserve electro-neutrality. Thus, the Cl:Na ratio could be used as a simple alternative to the anion gap in identifying raised TA. ⋯ In metabolic acidosis due to TA, plasma Cl concentration decreases relative to sodium. The Cl:Na ratio is a simple alternative to the AG for detecting TA in this setting.
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Intensive care medicine · May 2001
Statistical models to predict the need for postoperative intensive care and hospitalization in pediatric surgical patients.
To develop statistical models for predicting postoperative hospital and ICU stay in pediatric surgical patients based on preoperative clinical characteristics and operative factors related to the degree of surgical stress. We hypothesized that preoperative and operative factors will predict the need for ICU admission and may be used to forecast the length of ICU stay or postoperative hospital stay. ⋯ Preoperative and operative factors may be used to develop statistical models predicting the need for ICU admission in pediatric surgical patients, and hospital stay following general surgical, orthopedic, cardiothoracic and urologic procedures. These statistical models need to be refined and validatedfurther, perhaps using data collection from multiple institutions.