Journal of critical care
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Journal of critical care · Jun 1993
Systemic oxygen extraction can be improved during repeated episodes of cardiac tamponade.
We used a tamponade model to study the relationship between oxygen uptake (VO2) and oxygen delivery (DO2) during successive, reversible decreases in blood flow. In 7 pentobarbital-anesthetized and mechanically ventilated dogs, a catheter was introduced via a left thoracotomy into the pericardium to inject and to withdraw saline. Each experiment consisted of three steps. ⋯ There was no significant difference in VO2 at DO2crit for the three steps. Hence, critical oxygen extraction ratio (ERO2crit) increased from 60% +/- 12% in step 1 to 64% +/- 11% in step 2 (not significant) and to 73% +/- 12% in step 3 (P < .01). The VO2/DO2 dependency slope was also steeper in step 3 than in step 1 (0.77 +/- 0.31 v 0.54 +/- 0.20, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Journal of critical care · Jun 1993
Allocation of critical care resources: entitlements, responsibilities, and benefits.
Determination of allocation of limited critical care resources appears to be an inevitable development. Criteria proposed to assign such limited resources among patients are not defined. It has been argued that allocation of critical care resources could be based on the principals of patient entitlements to health care, responsibilities of the physician to the critically ill patient, and beneficence. However, based on an analysis of the philosophical tenants of the Hippocratic Oath, there is little to support the concept of "sin" taxes or patient triage on the basis of judgment on the moral merit of the patient.