Intensive care medicine
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Intensive care medicine · Apr 1997
Randomized Controlled Trial Clinical TrialUnfavorable mechanical effects of heat and moisture exchangers in ventilated patients.
To investigate the mechanical effects of artificial noses. ⋯ The artificial noses cause unfavorable mechanical effects by increasing inspiratory resistance, ventilation requirements, and dynamic intrinsic PEEP. Clinicians should consider these effects when setting mechanical ventilation and when assessing patients' ability to breathe spontaneously.
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Intensive care medicine · Apr 1997
Reliability of anion gap as an indicator of blood lactate in critically ill patients.
To evaluate the sensitivity, specificity, and predictive values of an elevated anion gap as an indicator of hyperlactatemia and to assess the contribution of blood lactate to the serum anion gap in critically ill patients. ⋯ An elevated anion gap is not a sensitive indicator of moderate hyperlactatemia, but it is quite specific, provided the other main causes of the elevated anion gap have been eliminated. Changes in blood lactate only account for about half of the changes in anion gap, and serum chloride does not seem to be an important factor in the determination of the serum anion gap.
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Intensive care medicine · Apr 1997
Quantitative estimation of errors in the indicator dilution measurement of extravascular lung water.
To assess the accuracy of the diffusible indicators heavy water and thermal indicator in the measurement of extravascular lung water (EVLW). ⋯ The results obtained for heavy water confirmed the theoretical basis of the indicator dilution method. The mean transit time for the thermal indicator was not proportionate to its distribution volume. The magnitude of this error prevents the calculation of an anatomically defined EVLW using a catheter-mounted thermistor in the aorta.
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Intensive care medicine · Apr 1997
Summary of round table conference: gut dysfunction in critical illness.
There is recent evidence that intestinal function is an important determinant in the outcome of critically ill patients. The barrier function is an important characteristic of the gut. ⋯ A practical bedside measure of gut dysfunction is intolerance to enteral feedings. Potential therapies for gut dysfunction include the use of vasoactive drugs to enhance perfusion, selective decontamination to decrease bacteria and endotoxin, and the early and frequent administration of enteral nutrients.