Intensive care medicine
-
Intensive care medicine · May 2000
The increase in CO2 production induced by NaHCO3 depends on blood albumin and hemoglobin concentrations.
To evaluate the origin of H+ ions participating in the generation of CO2 coming from sodium bicarbonate infusion during metabolic acidosis. We hypothesized that these H+ ions come from a back-titration of the main non-bicarbonate buffers present in the blood, i. e. the hemoglobin and the albumin, and thus postulated that the rate of CO2 release from a bicarbonate load is dependent on the concentration of these buffers. ⋯ The importance of the release of CO2 from a bicarbonate load is dependent on the concentration of the blood non-bicarbonate buffers. It is therefore likely that the adverse effects of bicarbonate therapy linked to the CO2 generation are more important in patients with high blood albumin and hemoglobin concentrations.
-
Intensive care medicine · May 2000
Comparative StudyAccuracy and reproducibility of long-term implanted transit-time ultrasound flow probes in dogs.
To assess the accuracy and reproducibility of long-term implanted ultrasound transit-time flow probes for measuring cardiac output. ⋯ After in vivo calibration, ultrasound transit-time flow probes measure cardiac output precisely for several years, regardless of the intervention.
-
Intensive care medicine · May 2000
Acute renal failure following cardiopulmonary bypass: a changing picture.
To assess the incidence of acute renal failure (ARF) developing perioperatively in adult patients requiring cardiopulmonary bypass surgery (CPB) and to make comparisons with data from the same institution published earlier. ⋯ The need for CVVH following CPB may be diminishing despite increased risk factors. ARF-associated mortality in these circumstances is falling.
-
Intensive care medicine · May 2000
Plasmapheresis combined with continuous venovenous hemofiltration in surgical patients with sepsis.
To examine the effect of continuous venovenous hemofiltration (CVVHF) combined with plasmapheresis (TPE) in critically ill surgical patients after treatment of the septic focus. ⋯ Reduction in mortality in single- and double-organ failure was as high as 28% in septic patients with combined extracorporeal detoxification. A prospective randomized trial in sepsis and double-organ failure should be projected.
-
Intensive care medicine · May 2000
Report from the meeting: Gastrointestinal Tonometry: State of the Art. 22nd-23rd May 1998, London, UK.
Gastrointestinal (GI) tonometry, the only clinically available method for the accurate diagnosis of compromised GI blood flow, has been shown to be a sensitive predictor of increased morbidity, mortality and prolonged hospitalization. The recent introduction of the Tonocap, as a means of performing automated air tonometry, has simplified the application of GI tonometry in the clinical setting. ⋯ The aim of the meeting was to come to a consensus regarding certain issues such as the past and future roles of GI tonometry and standards for its correct usage and interpretation. Finally suggestions as to further research and clinical evaluation were made within a broader discussion regarding the complexities of applying the principles of evidence-based medicine to the introduction of a new piece of medical technology.