Journal of critical care
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Journal of critical care · Mar 1995
ReviewPrevention of drug-induced nephrotoxicity in the intensive care unit.
Acute renal failure (ARF) occurs in 5% to 25% of all admissions to an intensive care unit (ICU). The development of ICU-associated ARF increases the average mortality from about 15% to more than 60%. ⋯ Recent studies suggest that a significant percent of hospital-acquired ARF is caused by nephrotoxins. This brief review will discuss the frequency of occurrence, pathophysiology, risk factors, clinical course, and prevention of nephrotoxicity that may occur after exposure to aminoglycosides, nonsteroidal anti-inflammatory drugs, and radiographic contrast agents.
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Journal of critical care · Mar 1995
Comparative StudyEnhancement of neutrophil function by in vivo filgrastim treatment for prophylaxis of sepsis in surgical intensive care patients.
To determine the kinetics of leukocyte counts and of oxygen radical production of neutrophils from postoperative/posttraumatic patients with or without infusion of filgrastim (recombinant human granulocyte colony-stimulating factor, rhG-CSF) as prophylaxis against sepsis. ⋯ Prolonged enhancement of neutrophil count and function induced by rhG-CSF may be useful in the prophylaxis of sepsis in posttraumatic/postoperative patients at high risk of sepsis.
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Journal of critical care · Mar 1995
Effect of infusion and withdrawl of glucose and insulin on gas exchange in injured ventilated patients.
To evaluate the effect induced on gas exchange and on urea excretion by glucose and insulin infusion in injured patients. The magnitude and time necessary for the full development of the metabolic effect were investigated. ⋯ The infusion of glucose and insulin, in an amount slightly lower than the metabolic expenditure, leads to a consistently reduced amino acid catabolism and to a decreased oxygen consumption, without affecting energy requirements. Although it leads to an increase of carbon dioxide production, the measured change is so small and slow that it is not harmful unless there is severe respiratory insufficiency.
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Journal of critical care · Mar 1995
An increase in low aortic pressure increases coronary artery flow and coronary thrombolysis induced by intravenous administration of recombinant tissue plasminogen activator.
Our study investigated the effects of an increase in aortic pressure, induced by norepinephrine (NE) administration on coronary artery flow in a clotted artery, and rate of coronary thrombolysis induced by intravenous (i.v.) administration of recombinant tissue plasminogen activator (rtPA). ⋯ These results indicate that an increase in a low coronary artery perfusion pressure may enhance coronary artery flow and the rate of thrombolysis.