Journal of critical care
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Journal of critical care · Jun 1995
Comparative StudyStrong ion gap: a methodology for exploring unexplained anions.
This paper describes the calculation of the strong ion gap (SIG), a physical chemical methodology similar to the anion gap (AG), as a measure of the anion/cation balance exclusive of sodium, potassium, chloride, and bicarbonate. We compared the SIG and AG methodologies in three groups of subjects with and without unexplained anions. These groups were (1) healthy volunteers with hyperlacticemia during exercise; (2) intensive care unit (ICU) patients with sepsis; and (3) ICU patients with severe liver disease. ⋯ The SIG correlates with the AG once corrected for all known anions. The SIG technique can detect unknown anions in a patient population known to have them and does not detect unknown anions in healthy volunteers during exercise. This test detects large amounts of unknown anions in some patients with sepsis or liver disease. Therefore, the test is both sensitive and specific in characterizing metabolic acidosis.
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Journal of critical care · Jun 1995
ReviewMolecular mechanisms of sepsis: molecular biology of the cell.
Complex and interrelated biological processes are at work in the expression of the host response to sepsis. To a large degree, these processes reflect drastic changes in the molecular workings of cells of the body. The protean nature of sepsis reflects this molecular adaptation. ⋯ It uses the process of endotoxin-induced cellular activation as its model and highlights important aspects of DNA promoter and enhancer processes in this activation. Specific examples of known promoter genes and genomic translation are described. This review serves as a "primer" for the subsequent three review articles in this series that will follow it in preceding issues.
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Journal of critical care · Jun 1995
Do synthetic adrenergic agents interfere with the measurement of endogenous plasma catecholamine concentrations?
It is common to administer synthetic sympathomimetic and sympatholytic agents in the intensive care unit and operating room. The present study examines whether such agents, as well as the products of catecholamine metabolism, interfere with the quantitation of endogenous catecholamines by high-performance liquid chromatography. ⋯ Synthetic adrenergic agents and catecholamine metabolites can potentially interfere with the quantitation of the endogenous catecholamines. Thus, it is important to examine whether such interference occurs when conducting high-performance liquid chromatography assays.
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Journal of critical care · Jun 1995
Comparative StudyNeuromuscular blockade provides no benefit over adequate sedation in ventilated dogs.
To investigate the effect of pharmacological paralysis on systemic oxygen consumption to determine whether pharmacological paralysis offers a physiological benefit over adequate sedation in ventilated animals. ⋯ Pharmacological paralysis of mechanically ventilated animals with normal pulmonary function that are sedated and resting comfortably produces a statistically significant reduction in oxygen consumption; however, the magnitude of this change is so small that little genuine clinical benefit would be anticipated.