Intensive care medicine
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Intensive care medicine · May 1996
Case ReportsHyperthermia complicating tricyclic antidepressant overdose.
We observed a 51-year-old woman who was admitted for severe amitriptyline overdose. Besides major cardiovascular complications, the patient developed severe hyperpyrexia with a central body temperature of more than 43 degrees C for 5 h. ⋯ Hyperthermia was unresponsive to cooling with ice water, gastric lavage, muscle relaxation, and dantrolene and bromocriptine administration. The possible mechanisms of refractory hyperthermia are discussed.
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Intensive care medicine · May 1996
Do cardiac output and serum lactate levels indicate blood transfusion requirements in anemia of prematurity?
Whether and when to transfuse in anemia of prematurity is highly controversial. Some authors suggest transfusions simply if the hemoglobin (Hb) level is below a defined normal range. Others propose the use of clinical or laboratory parameters in anemic patients to decide whether to transfuse or not. ⋯ CO measurements and serum lactate levels add little information to the decision-making process for blood transfusions, as neither CO nor serum lactate levels correlate with HB levels in an otherwise asymptomatic population of preterm infants. In infants where the indication for blood transfusion is made based on traditionally accepted clinical criteria, serum lactate is an additional laboratory indicator of impaired oxygenation, as it correlates significantly with oxygen delivery. A significant lower oxygen delivery in patients in whom blood transfusion is indicated and an increase in oxygen induced by transfusion demonstrate the value of these criteria in identifying preterm infants who benefit from transfusion.
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Intensive care medicine · May 1996
The effect of mannitol on intracranial pressure in relation to serum osmolality in a cat model of cerebral edema.
To determine whether intravenous mannitol administration reduces intracranial pressure (ICP) in a cat model of brain edema by changing serum osmolality. ⋯ Mannitol is effective in reducing increased ICP in this model of euvolemic brain edema. However, 15 min after mannitol administration, no relationship between a continued decrease in ICP and a change in serum osmolality could be established. We postulate that the beneficial effect on ICP by mannitol outlasts its possible instantaneous and short-lived effect on serum osmolality.
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Intensive care medicine · May 1996
Multicenter Study Comparative Study Clinical TrialClinical evaluation of a multiparameter intra-arterial blood-gas sensor.
To evaluate the in vivo performance of a continuous, intra-arterial, multiparameter blood-gas sensor containing a thermocouple, miniaturized polarographic oxygen electrode, as well as fiberoptic pH and pCO2 sensors. ⋯ Clinical performance of this intra-arterial, multiparameter blood-gas sensor demonstrated stability, consistency, and accuracy comparable to laboratory blood-gas analyzers. The present multiparameter, intravascular blood-gas sensor, when inserted in the radial artery, can provide stable and accurate monitoring of pH, PaCO2, and PaO2 over clinically relevant periods of as long as 6 days in the critical care setting.
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Intensive care medicine · May 1996
Comparative Study Clinical Trial Controlled Clinical TrialThe effect of single-dose and continuous skeletal muscle paralysis on respiratory system compliance in paediatric intensive care patients.
To investigate the effect of single dose and continuous skeletal muscle paralysis on respiratory system compliance in 53 paediatric intensive care patients. ⋯ Skeletal muscle paralysis results in immediate and progressive deterioration of respiratory system compliance and increased incidence of nosocomial pneumonia. The benefits of paralysis should be balanced against the risks of deteriorating pulmonary function.